Travin M, Macris N T, Block J M, Schwimmer D
Department of Medicine, Lenox Hill Hospital, New York, NY 10021.
Arch Intern Med. 1989 Jun;149(6):1421-2.
Phenytoin-induced panhypogammaglobulinemia mimicking the common variable immunodeficiency syndrome is rare. We describe a patient who, while being treated with phenytoin and corticosteroids, developed panhypogammaglobulinemia, recurrent pneumonia, eosinophilia, and a transient rash. Immunoglobulin levels, which had been normal prior to phenytoin therapy, returned to normal over a period of several months after the drug therapy was stopped. Levels of IgG subclasses and numbers of B cells, T cells, and T-cell subsets were determined during the recovery period. In a review of the reported cases, eosinophilia and rashes were frequently noted. These findings, along with recurrent infections in a patient receiving phenytoin therapy, should prompt a careful evaluation of the patient's immunologic status.
苯妥英钠诱发的全血细胞减少症模仿常见可变免疫缺陷综合征的情况很罕见。我们描述了一名患者，在接受苯妥英钠和皮质类固醇治疗期间，出现了全血细胞减少症、复发性肺炎、嗜酸性粒细胞增多症和短暂性皮疹。苯妥英钠治疗前免疫球蛋白水平正常，停药后数月内恢复正常。在恢复期测定了IgG亚类水平以及B细胞、T细胞和T细胞亚群的数量。在对报告病例的回顾中，经常注意到嗜酸性粒细胞增多症和皮疹。这些发现，以及接受苯妥英钠治疗的患者反复感染，应促使对患者的免疫状态进行仔细评估。
