Zidar B L, Mendelow H, Winkelstein A, Shadduck A K
Am J Med. 1975 May;58(5):704-8. doi: 10.1016/0002-9343(75)90507-0.
In this 16 year old boy a syndrome, characterized by high fever, generalized lymphadenopathy, splenomegaly, diffuse skin rash, facial and periorbital edema, neutropenia, thrombocytopenia, elevated serum glutamic oxaloacetic transaminase (SGOT) levels and transient electrocardiographic changes, appeared 2 weeks after the institution of diphenylhydantoin therapy. Lymph node biopsy, performed at the height of the illness, revealed widespread subendothelial fibrin exudation and fibrin-platelet thrombi in the lymph node microvasculature, a finding most consistent with thrombotic thrombocytopenic purpura. Although many types of abnormal lymph node histology have been described with diphenylhydantoin, this appears to be the first instance of this histologic picture. This syndrome may be related to a serum sickness-like illness which triggered an episode of localized coagulopathy.
在这名16岁男孩中，一种综合征在开始使用苯妥英治疗2周后出现，其特征为高热、全身淋巴结病、脾肿大、弥漫性皮疹、面部和眶周水肿、中性粒细胞减少、血小板减少、血清谷草转氨酶（SGOT）水平升高以及短暂的心电图改变。在疾病高峰期进行的淋巴结活检显示，淋巴结微血管广泛存在内皮下纤维蛋白渗出和纤维蛋白 - 血小板血栓，这一发现与血栓性血小板减少性紫癜最为相符。虽然已经描述了许多与苯妥英相关的异常淋巴结组织学类型，但这种组织学表现似乎是首例。该综合征可能与一种血清病样疾病有关，后者引发了局部凝血病发作。
