Immunoglobulin phenytoin

An 87-year-old white woman treated with vancomycin and phenytoin and a 65-year-old white man with renal insufficiency developed linear immunoglobulin A bullous disease (79,80). 

Hypersensitivity reactions include morbilliform rash in 2—5% of patients and occasionally more serious skin reactions, including Stevens-Johnson syndrome. Systemic lupus erythematosus and potentially fatal hepatic necrosis have been reported rarely. Hematological reactions include neutropenia and leucopenia, or more rarely, red-cell aplasia, agranulocytosis, and thrombocytopenia Lymphadenopathy is associated with reduced immunoglobulin A (IgA) production. Hypoprothrombinemia and hemorrhage have occurred in the newborns of mothers who received phenytoin during pregnancy vitamin K is effective treatment or prophylaxis. 

An isolated report describes an epileptic patient taking phenytoin who died, probably from hypersensitivity myocarditis, two days after receiving immunoglobulins for Guillain-Barre syndrome. 

Urinary tract Fibrillary glomerulonephritis, a rare form of glomerulopathy with immunoglobulin deposition, has been associated with phenytoin in a patient with epilepsy [249- ]. 

Fidan E, Fidan M, Ozdemir F, Kavgaci H, Aydin F. Phenytoin- and cranial radiotherapy-induced toxic epidermal necrolysis treated with combination therapy systemic steroid and intravenous immunoglobulin. Med Oncol June 2012 29(2) 686-9. 

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