Abstract
Phenytoin (DPH) was Riven in a loading dose (6mg/kg/dose × 4 then daily) or a high conventional dose (5.5-9.5 mg/kg/d) to 13 epileptic children. About 8-10 d after the first dose a generalized maculo-papular, erythematous exanthen appeared tilth an unexpected hich frequency: 4/5 (80%) for loaded and 5/8 (63%) for high conventional doses (Wilson et al CPT 20, 48, 1976). In a prospective trial, DPH was given to ten epileptic children as either a graded dose (3 mg/kg/d × 5 days then 6 mg/kg/d) or a conventional dose (6 mg/kg/d). An exanthem was apain found: 4/5 (80%) for conventional and 1/5 (20%) for graded regimen. A relationship to dose was thus apparent. Data were analysed from all patientis with regard to occurence of the exanthem. Those with an exanthem showed higher average plasma levels of DPH during the first 8-14 days and higher ratio of level to dose. The ratio of total p-OH-DPH (a primary metabolite of DPH) to DPH in plasma was lower for those with a rash and who received loading or high conventional doses. plasma protein binding of DPH showed no difference in those with or without an exanthem. A high plasma level of DPH, via dose or decreased metabolism, was associated with occurence of the exanthem. This association, here demonstrated for the first time in man, raises questions about the “toxic” vs “allergic” nature of drug associated exanthemas. (Supported by Swedish MRC 04×04496 and K4-HD42-539 from the NIH)
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wilson, J., Ran, E. & Thomso, N. HIGH INCIDENCE OF A GENERALIZED EXANTHEM IN EPILEPTIC CHILDREN AND ITS RELATION TO PLASMA LEVELS OF PHENYTOIN. Pediatr Res 11, 422 (1977). https://doi.org/10.1203/00006450-197704000-00320
Issue Date:
DOI: https://doi.org/10.1203/00006450-197704000-00320