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  • Title: Phenytoin hypersensitivity hepatitis and mononucleosis syndrome.
    Author: Brown M, Schubert T.
    Journal: J Clin Gastroenterol; 1986 Aug; 8(4):469-77. PubMed ID: 3093562.
    Abstract:
    We present a patient who developed a mononucleosis syndrome 6 weeks after starting phenytoin therapy for a seizure disorder. Improvement followed initial discontinuation of the phenytoin, but near-fatal hepatic necrosis resulted from intravenous phenytoin rechallenge. A serious reaction with a 18% overall mortality, phenytoin hepatitis may closely resemble infectious mononucleosis with fever, pharyngitis, lymphadenopathy, and atypical lymphocytosis. Continued administration of phenytoin or later rechallenge may increase the severity of the reaction.
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