Black D M, Fivenson D P
University of Cincinnati, Ohio 45267.
Fam Pract Res J. 1989 Spring-Summer;8(2):107-11.
Antiepileptic medication is widely prescribed for many neurological conditions, especially seizures. Although adverse reactions are noted, they generally fall into a category of mild effects which necessitate a therapeutic change--and little evaluation. We present a case of a severe reaction to two antiseizure medications. Characteristic findings of lymphadenopathy, fever, exfoliative dermatitis, eosinophilia and hepatic damage are well described as a hypersensitive reaction to phenytoin, often called "pseudolymphoma." Phenobarbital also produces a clinically indistinguishable syndrome of pseudolymphoma, which is not widely recognized. A case report and review of the literature are presented. We conclude that phenytoin and phenobarbital hypersensitivity reactions are probably mediated by a similar mechanism. This appears to be an extreme extension of the more common and less severe reactions to these medications. Clinical studies in primary care can better elucidate this potentially fatal reaction.
抗癫痫药物被广泛用于多种神经系统疾病的治疗，尤其是癫痫发作。尽管会出现不良反应，但这些反应通常属于轻度范畴，只需进行治疗调整，且很少进行评估。我们报告一例对两种抗癫痫药物产生严重反应的病例。淋巴结病、发热、剥脱性皮炎、嗜酸性粒细胞增多和肝损伤等特征性表现被充分描述为对苯妥英钠的过敏反应，通常称为“假性淋巴瘤”。苯巴比妥也会产生临床上难以区分的假性淋巴瘤综合征，但该综合征并未得到广泛认识。本文呈现了一例病例报告并对相关文献进行综述。我们得出结论，苯妥英钠和苯巴比妥的过敏反应可能由相似机制介导。这似乎是对这些药物更常见、不太严重的反应的极端表现。初级保健中的临床研究能够更好地阐明这种潜在致命反应。
