ACUTE HEPATIC NECROSIS WITH DEATH OCCURRING DURING PHETHENYLATE SODIUM THERAPY

Abstract

Phethenylate ("thiantoin") sodium or "thyphenytoin" (5-phenyl-5-[2-thienyl] hydantoinate) was first prepared in 1941. The initial clinical results, however, were not published until 1948, when Peterman¹ reported on a series of 73 children with convulsions who were treated with the drug for two years. His results indicated that phethenylate was effective in controlling both grand mal and petit mal seizures. The toxic side-reactions were relatively insignificant and consisted of hyperplasia of the gums, ataxia and incoordination, and rash. In 1950 Carter and Merritt² reported that phethenylate sodium was ineffective in treatment of petit mal seizures. We have treated 153 patients with phethenylate over a period of three years. We observed that the drug was somewhat effective in the control of grand mal seizures, but was not appreciably beneficial in treatment of petit mal and psychomotor seizures. In addition to the untoward reactions reported by Peterman, jaundice has been noted by