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A Case Report and Review of the Literature

JOHN L. PENNY, MD

Arch Intern Med. 1963;111(6):744-749.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Diphenylhydantoin (Dilantin) has been used extensively as anticonvulsant therapy since its introduction in 1938, as has phenobarbital since 1912. It was not until 1952 that Mannheimer et al.¹ described leukopenia and megaloblastic anemia in an epileptic patient being treated with diphenylhydantoin. After the administration of cyanocobalamin (vitamin B₁₂) the blood gradually returned to normal. Badenoch² in 1954 was the first to suggest a causal relationship between megaloblastic anemia and anticonvulsant medication in two case reports. Diphenylhydantoin, primidone (Mysoline), and barbiturates either singly or in combination have been shown capable of inducing megaloblastic anemia.

The purpose of this report is to describe a case of megaloblastic anemia associated with diphenylhydantoin and phenobarbital therapy and to review the literature on this subject.

Report of Case

A 50-year-old white woman entered St. Vincent's Hospital for the first time on Dec. 7, 1961, because of increasing weakness and shortness of breath . . . [Full Text PDF of this Article]

Author Affiliations
NEW YORK

From the Department of Medicine, St. Vincent's Hospital.; Former Medical Resident, St. Vincent's Hospital; presently Captain, U.S. Army.

Footnotes
Received for publication Oct. 10, 1962; accepted Nov. 28.

Dr. William J. Grace, Director of Medicine, and Dr. Zackery Komnios, Director of Hematology, both of St. Vincent's, New York; Col William H. Crosby, Jr, Director of Hematology, Walter Reed General Hospital, Washington, DC, and Dr. Theodore B. Van Itallie, Director of Medicine, St. Luke's Hospital, New York, gave assistance in preparing this article.

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