Title:Cutaneous Hypersensitivity Reaction After Phenytoin Therapy in a Neonate:
A Case Report and Review of Literature Elucidating the Potential
Pharmacological Plausibility and Preventive Strategies
Volume: 18
Issue: 4
Author(s): Praveenkumar Rajendran, Indumathi Prabath*Jamuna Rani
Affiliation:
- Department of Pharmacology, SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, India
Keywords:
Hypersensitivity reactions, phenytoin, neonates, generalized tonic-clonic seizures, infant, phottotherapy.
Abstract:
Background: Drug-induced hypersensitivity reaction is a potentially life-threatening
condition reported among patients of different age groups. Phenytoin is a prototypic drug
prescribed for the treatment of a variety of seizure disorders. Allergic reaction to phenytoin therapy
in a newborn is relatively a rare clinical manifestation that is not frequently reported.
Objective: The objective of this study is to report a suspected case of hypersensitivity reaction in a
newborn possibly due to phenytoin and the strategies to prevent these immune-mediated reactions.
Case Report: An early term newborn on the 4th day of life developed erythematous rashes over the
abdominal region following phenytoin treatment for recurrent generalized tonic-clonic seizures.
Prenatal history was uneventful except for the mother had preeclampsia during the third trimester
of pregnancy. The suspected phenytoin was replaced with phenobarbitone to control seizure
episodes. Subsequently, the rashes disappeared. The baby had also suffered from skin
discolouration after phototherapy. Radiological investigations and cerebrospinal fluid culture were
performed to detect the etiology of seizures.
Conclusion: Hypersensitivity reaction to phenytoin in newborns is a rare clinical entity but may
lead to serious lethal complications. Thus, stringent clinical monitoring of patients on phenytoin
therapy is mandatory, especially in the pediatric population.
