• J Formos Med Assoc · Aug 2004

    Case Reports

    Charcoal hemoperfusion in an elderly man with life-threatening adverse reactions due to poor metabolism of phenytoin.

    • Sheng-Feng Sung, Pei-Chun Chiang, Hsiu-Hua Tung, and Cheung-Ter Ong.
    • Department of Neurology, Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
    • J Formos Med Assoc. 2004 Aug 1;103(8):648-52.

    AbstractA 77-year-old man presented with dizziness and ataxia after 7-day treatment of phenytoin 100 mg 3 times daily for prophylaxis of post-traumatic seizure. Thrombocytopenia and hematuria were found incipiently and supportive measures were employed. Owing to extremely slow metabolism of phenytoin in this patient, the period of exposure to phenytoin overdose was prolonged, resulting in delayed hypersensitivity syndrome. Neutropenia and fever developed and thus antibiotics and granulocyte-colony stimulating factor were administered. Although charcoal hemoperfusion is generally not applied in cases of phenytoin overdose, this method was successfully used to enhance the removal of phenytoin in our patient.

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