A case of amyloidosis associated with diphenylhydantoin therapy. 1989

S Nomura, and G Osawa, and T Sato, and T Ishimatsu, and T Shindo, and H Hirano
Department of Medicine, Kawasaki Medical School, Okayama, Japan.

Prolonged administration of diphenylhydantoin (DPH) has been implicated as a possible etiologic factor in immunological aberrations and lymphoproliferative disorders. Diphenylhydantoin may account for the increase in susceptibility to lymphoproliferative diseases, as a result of its immunosuppressive effect. We report a case of amyloidosis with monoclonal gammopathy which developed during DPH treatment, without multiple myeloma or lymphoproliferative disorders. The association between DPH and monoclonal gammopathy is very rare, and such a case of amyloidosis associated with DPH has not been reported previously. DPH, however, may have played a role in the development of monoclonal gammopathy, which was the precursor of amyloid protein.

UI MeSH Term Description Entries
D007678 Kidney Glomerulus A cluster of convoluted capillaries beginning at each nephric tubule in the kidney and held together by connective tissue. Glomerulus, Kidney
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009404 Nephrotic Syndrome A condition characterized by severe PROTEINURIA, greater than 3.5 g/day in an average adult. The substantial loss of protein in the urine results in complications such as HYPOPROTEINEMIA; generalized EDEMA; HYPERTENSION; and HYPERLIPIDEMIAS. Diseases associated with nephrotic syndrome generally cause chronic kidney dysfunction. Childhood Idiopathic Nephrotic Syndrome,Frequently Relapsing Nephrotic Syndrome,Multi-Drug Resistant Nephrotic Syndrome,Pediatric Idiopathic Nephrotic Syndrome,Steroid-Dependent Nephrotic Syndrome,Steroid-Resistant Nephrotic Syndrome,Steroid-Sensitive Nephrotic Syndrome,Multi Drug Resistant Nephrotic Syndrome,Nephrotic Syndrome, Steroid-Dependent,Nephrotic Syndrome, Steroid-Resistant,Nephrotic Syndrome, Steroid-Sensitive,Nephrotic Syndromes,Steroid Dependent Nephrotic Syndrome,Steroid Resistant Nephrotic Syndrome,Steroid Sensitive Nephrotic Syndrome,Steroid-Dependent Nephrotic Syndromes,Steroid-Resistant Nephrotic Syndromes,Steroid-Sensitive Nephrotic Syndromes,Syndrome, Nephrotic,Syndrome, Steroid-Sensitive Nephrotic
D010672 Phenytoin An anticonvulsant that is used to treat a wide variety of seizures. It is also an anti-arrhythmic and a muscle relaxant. The mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. The mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. Phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs. Diphenylhydantoin,Fenitoin,Phenhydan,5,5-Diphenylhydantoin,5,5-diphenylimidazolidine-2,4-dione,Antisacer,Difenin,Dihydan,Dilantin,Epamin,Epanutin,Hydantol,Phenytoin Sodium,Sodium Diphenylhydantoinate,Diphenylhydantoinate, Sodium
D004834 Epilepsy, Post-Traumatic Recurrent seizures causally related to CRANIOCEREBRAL TRAUMA. Seizure onset may be immediate but is typically delayed for several days after the injury and may not occur for up to two years. The majority of seizures have a focal onset that correlates clinically with the site of brain injury. Cerebral cortex injuries caused by a penetrating foreign object (CRANIOCEREBRAL TRAUMA, PENETRATING) are more likely than closed head injuries (HEAD INJURIES, CLOSED) to be associated with epilepsy. Concussive convulsions are nonepileptic phenomena that occur immediately after head injury and are characterized by tonic and clonic movements. (From Rev Neurol 1998 Feb;26(150):256-261; Sports Med 1998 Feb;25(2):131-6) Concussive Convulsion,Epilepsy, Traumatic,Impact Seizure,Seizure Disorder, Post-Traumatic,Early Post-Traumatic Seizures,Late Post-Traumatic Seizures,Post-Traumatic Seizure Disorder,Concussive Convulsions,Convulsion, Concussive,Convulsions, Concussive,Disorder, Post-Traumatic Seizure,Disorders, Post-Traumatic Seizure,Early Post Traumatic Seizures,Early Post-Traumatic Seizure,Epilepsies, Post-Traumatic,Epilepsies, Traumatic,Epilepsy, Post Traumatic,Impact Seizures,Late Post Traumatic Seizures,Late Post-Traumatic Seizure,Post Traumatic Seizure Disorder,Post-Traumatic Epilepsies,Post-Traumatic Epilepsy,Post-Traumatic Seizure Disorders,Post-Traumatic Seizure, Early,Post-Traumatic Seizure, Late,Post-Traumatic Seizures, Early,Post-Traumatic Seizures, Late,Seizure Disorder, Post Traumatic,Seizure Disorders, Post-Traumatic,Seizure, Early Post-Traumatic,Seizure, Late Post-Traumatic,Seizures, Early Post-Traumatic,Seizures, Late Post-Traumatic,Traumatic Epilepsies,Traumatic Epilepsy
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006942 Hypergammaglobulinemia An excess of GAMMA-GLOBULINS in the serum due to chronic infections or PARAPROTEINEMIAS. Hyperimmunoglobulinemia,Hypergammaglobulinemias,Hyperimmunoglobulinemias
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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