Taylor J W, Stein M N, Murphy M J, Mitros F A
Arch Neurol. 1984 May;41(5):500-1. doi: 10.1001/archneur.1984.04050170046014.
Cholestatic jaundice developed in a 64-year-old woman who had received phenytoin sodium for more than 40 years. Discontinuation of phenytoin therapy resulted in resolution of the hepatic abnormalities, which recurred on rechallenge, strongly suggesting a causal relation to the drug. Phenytoin therapy was discontinued again, with complete resolution of the hepatic abnormalities. The liver biopsy specimen obtained during therapy showed cholestasis compatible with obstruction of the biliary tree, although an obstructive process was never demonstrated. The biochemical abnormalities and histologic features observed most likely represent an unusual response to phenytoin therapy.
一名64岁女性在服用苯妥英钠40多年后出现胆汁淤积性黄疸。停用苯妥英治疗后肝脏异常情况消失，再次用药时异常情况复发，强烈提示与该药物存在因果关系。再次停用苯妥英治疗后，肝脏异常完全消失。治疗期间获取的肝活检标本显示胆汁淤积，符合胆管树梗阻，但从未证实存在梗阻性病变。观察到的生化异常和组织学特征很可能代表了对苯妥英治疗的一种异常反应。
