Gaffey C M, Chun B, Harvey J C, Manz H J
Arch Pathol Lab Med. 1986 Feb;110(2):131-5.
Much has been written about adverse effects accompanying the use of phenytoin. However, the rare occurrence of systemic vasculitis induced by this drug has only been the subject of sporadic case reports and has not truly been characterized as a definitive entity. The high fatality rate of this complication is a proof of its severity. A case of multiorgan necrotizing granulomatous vasculitis related to the use of phenytoin is reported and the clinicopathologic aspects of seven similar cases assembled from the literature are summarized and discussed. The most commonly affected patients are elderly black men who present with skin rash, fever, and, frequently, eosinophilia. Tissue examination discloses systemic vasculitis that is often granulomatous and involves mainly the liver, kidneys, and spleen. Immediate recognition of this diagnosis is stressed, since proper treatment may reverse a fatal clinical course.
关于使用苯妥英钠伴随的不良反应已有大量著述。然而，这种药物诱发的系统性血管炎罕见，仅成为零星病例报告的主题，尚未真正被界定为一种明确的病症。这种并发症的高死亡率证明了其严重性。本文报告了一例与使用苯妥英钠相关的多器官坏死性肉芽肿性血管炎病例，并总结和讨论了从文献中收集的7例类似病例的临床病理特征。最常受影响的患者是老年黑人男性，表现为皮疹、发热，且常伴有嗜酸性粒细胞增多。组织检查显示系统性血管炎，通常为肉芽肿性，主要累及肝脏、肾脏和脾脏。强调要立即识别这一诊断，因为恰当的治疗可能扭转致命的临床病程。
