Severe Hypersensitivity to Diphenylhydantoin with Circulating Antibodies to the Drug

Abstract

An infrequent adverse reaction to diphenylhydantoin (DPH) is a mononucleosis-like syndrome (1, 2). We report here on such a patient, in whom polyclonal IgG antibodies to DPH were detected. A 15-year-old black high school student was admitted to the University of Illinois Hospital because of fever, skin rash, myalgia, and dark urine. Ten weeks previously he had a convulsive seizure, and diphenylhydantoin, 100 mg three times daily, was prescribed. Seven weeks later a pruritic rash started on his trunk. It gradually spread and was accompanied by fever, myalgia, anorexia, and malaise. On the day of admission his urine turned dark.