Abstract
A 3 year old boy was treated with diphenylhydantoin (DPH), ethosuximide (E), and phenobarbital for convulsions following herpes encephalitis. After 3 months of anticonvulsant treatment he developed NS (24 hour uriae protein-9.1 grams, serum albumin-0.76 gms.%, cholesterol-356 mg.%), positive ANIF (1:800), “suspiciously” positive LE preparation, positive skin biopsy (dermalepidermal IgG), and high total eosinophil count (985 - nl 50-250)., After withdrawal of DPH and E there was gradual resolution of NS and normalization of urine, serum protein, cholesterol, ANIF and eosinophilla. Renal function and serum complement levels remained normal. Corticosteroids were not given.
Although anticonvulsants have been associated with SLE-like syndromes, serologic abnormalities, nephritis or NS, no previously reported patient developed SLE and NS concurrently. The urgency in discontinuing DPH and E prevented our identifying the offending drug. It is likely that this patient sustained a syndrome of drug-induced SLE with immune-mediated reversible glomerulonephritis and NS.
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Aronson, A., Ezzati, M., Soltani, K. et al. ANTICONVULSANT-INDUCED SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) AND NEPHROTIC SYNDROME (MS). Pediatr Res 11, 546 (1977). https://doi.org/10.1203/00006450-197704000-01059
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DOI: https://doi.org/10.1203/00006450-197704000-01059