雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

A CASE OF STEVENS-JOHNSON SYNDROME ASSOCIATED WITH IATROGENIC ANTICONVULSANT DRUG LYMPHADENOPATHY CAUSED BY DIPHENYLHYDANTOIN-Na AND PHENACEMIDE Yoshimasa SAKAMOTO 1 , Shozo TORII 2 , Mutsuhiro FURUTA 3 1Dept. of Pediatrics Kansai Medical School 2Dept. of Pediatrics The Japan Baptist Hospital 3Dept. of Pathotogy The Japan Baptist Hospital pp.691-697
Published Date 1964/8/1
DOI https://doi.org/10.11477/mf.1406206463
  • Abstract
  • Look Inside

A rare case is reported of so-called mucocutaneous ocular sydrome associated with iatrogenic anticon-vulsant drug lymphadenopathy caused by Diphenyl-hidantoin-Na and reactivated by Phenacemide.

An 11-year-old boy had his initial convulsion fol-lowed by physical retardation at 10 months of age. His second attack was of psychomoter type at 8 years of age. He was treated with Diphenylhydantoin-Na and Prominal for 2 years and 2 months without side effects or convulsions. However, he developed high fever suddenly at 11 years of age. on the 3rd day he began to have generahzed convulsions and on the 4th day a reddish measles like rash started on the face and then spread gradually over the body. On the 10th day generalized painful swelling of the lymphnodes was noted. The skin rash gradually changed to a scarlet-fever-like or exfoliative derma-titis and became severe. At the time of admission, 3 weeks after the onset of fever, clinical and labora-tory lindings were as follows; persistent fever, leuco-cytosis with eosinophilia, β-hemolytic streptococcal tonsillitis, severe stomatitis, urethritis and conjuncti-vitis; i.e. the so-called mucocutaneous ocular syndro-me, especially Stevens-Johhsan syedrome. His gene-ral condition deteriorated, with a hemolytic tendency and severe liver and renal damage with jaundice. However, improvemet follwed the discontinuation of Diphenylhydantoin-Na and medication with ACTH and β-methasone. Lymphnode biopsy showed destruc-tion of lymph follicles, proriferattion of reticulum cells and appearance of large phagocytes with brown pigment. Skin biopsy revealed hyper- and parakera-tosis but renal biopsy showed no sign of collagen disease.

The patient recovered, but the same disease was reactivaied by administration of only 0.5g of Phenacemide which was tried for continuing con-vulsions.

In the Pathogenesis of anticonvulsant drug lym-phadenopathy with mucocutaneous ocular symdrome, the authors considered the precipitating factor to be a streptococcal or viral infection since the ASL-O titer and the Paul-Bunel test.


Copyright © 1964, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

関連文献

もっと見る

文献を共有