Phenytoin
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Pure red cell aplasia: case report A 24-year-old man developed pure red cell aplasia during treatment with phenytoin for generalised tonic-clonic seizure (GTCS). The man presented due to generalised weakness and easy fatigability from last one month, without any bleeding manifestation, fever or any feeling of abdominal heaviness. His medical history was significant for GTCS, for which he had been receiving phenytoin [dosage and route not stated] for the previous 4 months with good compliance. On physical examination, pallor was observed without any systemic findings. Laboratory investigations revealed the following: normocytic anaemia with normal total leucocyte count (TLC) and platelet counts. The iron studies were found to be within normal limits. Reticulocyte count was found to be reduced to 0.6%. A bone marrow examination showed severe erythroid hypoplasia with normal platelets and WBC lineage. Autoimmune markers, Epstein-Barr virus (EBV) IgM antibody, parvovirus B19 were all negative. A contrast-enhanced CT-scan of the thorax did not show any evidence of thymoma. Based on above mentioned results, he was diagnosed with phenytoin-induced pure red cell aplasia. The man’s treatment with phenytoin was therefore discontinued. At a subsequent follow-up, a clinical improvement was seen, and the Hb level was also found to be improved. Kumar C, et al. Phenytoin induced pure red cell aplasia. Indian Journal of Hematology and Blood Transfusion 35: S71-S72 abstr. 31, Oct 2019. Available from: URL: http:// 803502840 doi.org/10.1007/s12288-019-01207-5 [abstract]
0114-9954/20/1823-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 26 Sep 2020 No. 1823
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