PANCYTOPENIA FROM "MESANTOIN"

Abstract

"Mesantoin" (3-methyl-5,5-phenylethyl hydantoin) is one of the newer anticonvulsant drugs and is chemically and pharmacologically related to "dilantin" (diphenylhydantoin sodium). Kozol¹and Loscalzo²reported that this drug is effective in the control of grand mal seizures and may be useful in patients who are refractory or intolerant to "dilantin." They noted no serious toxicities, although "in about 40 per cent of the cases the lymphocytes were moderately increased at the expense of the neutrophiles."²Cutaneous eruptions have occurred in 4.5 to 14 per cent of the cases,³and Ruskin⁴recently reported a fatal case of dermatitis bullosa medicamentosa due to "mesantoin." A search of the literature reveals only mention of 1 case of serious blood dyscrasia ascribed to "mesantoin" alone.⁵On review of the case of fatal aplastic anemia following the use of "tridione" (trimethadione) reported by Harrison and his co-workers;⁶it is