Diphenylhydantoin-induced hypogammaglobulinemia in a patient infected with human immunodeficiency virus
Article Abstract:
Patients infected with the human immunodeficiency virus (HIV) sometimes suffer from seizures even though no specific abnormality is evident. These patients are generally given diphenylhydantoin to prevent such seizures. This drug can cause a number of side effects, including hypogammaglobulinemia, a depletion of plasma proteins that contain antibodies. The case is reported of a 27-year-old HIV-infected man who was first seen in 1986 following a drug overdose, apparently a suicide attempt. At that time, he had borderline hypergammaglobulinemia (excess gammaglobulin), and tested positive for hepatitis B. Two and a half years later, he was found unconscious at his home and brought in for examination. A seizure was suspected and drug therapy with diphenylhydantoin was initiated, although examination found no specific cause for the seizure. Six months later he returned for examination. He had continued drug therapy and had no further seizures. Tests showed his lymph nodes were enlarged and his gammaglobulin levels were now low. Diphenylhydantoin therapy was withdrawn and within a week his gammaglobulin levels began to return to normal and his lymph nodes decreased toward normal size. Gammaglobulin levels remained normal. These results indicate a direct cause-and-effect relationship between drug therapy with diphenylhydantoin and hypogammaglobulinemia in HIV-infected patients. This effect is not normally seen in other patients. Further research needs to be done to see if this type of drug therapy in HIV-infected patients exaggerates an already weakened immune system. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Dapsone for thrombocytopenic purpura related to human immunodeficiency virus infection
Article Abstract:
Autoimmune thrombocytopenic purpura (AITP) is a systemic illness in which the platelet (cells which help preserve clotting mechanism in blood) count decreases and easy bruising of the skin occurs, along with a tendency to bleed. It is often seen in patients infected with the human immunodeficiency virus (HIV). A suitable treatment for this problem has not yet been found. This study examined the effectiveness of the drug dapsone to treat AITP in HIV-infected patients. The idea behind such therapy is that dapsone might be able to inhibit the destruction of platelets by macrophages, cells of the immune system that engulf cells and other matter identified as 'foreign'. Eleven HIV-infected patients with AITP were treated with 50 to 125 mg dapsone/day for between 2 and 43 months. The patients did not yet have AIDS and had not received antiviral therapy. Platelet counts were measured before, during, and after drug therapy. Results showed that platelet counts rose after therapy in 9 of the 11 patients, with counts rising above 50 billion per liter of blood - significantly better than the counts of 27 billion/L before therapy. Increases were persistent in eight of the nine patients that responded. There were no significant side effects of the drug therapy beyond some mild hemolysis (red cell destruction). The results indicate dapsone may be useful for treating some HIV-related cases of AITP. The mechanism by which it works is not clear. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
User Contributions:
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