Drug-induced liver injury caused by Phenytoin

Abstract

Adverse events related to the use of medications are very frequent, and can cause anything from mild damage to the patient's death. Therefore, when present, they must be handled quickly and effectively. Treatment with anticonvulsants should be carefully monitored for the risk of hepatotoxicity that may result in DILI, leading to poor adherence to therapy. This study aimed to report an adverse event reported at a University Hospital in the Northern region of Paraná, southern Brazil, related to liver damage induced by phenytoin. Female patient 45 years old, had a convulsive episode and was medicated with phenytoin. After administration, she evolved with elevated liver enzymes, skin rash, aphthous lesions and pruritus. In the etiological investigation of liver disease, viral and bacterial agents were excluded. Liver biopsy was compatible with acute hepatitis, suspecting a drug reaction. The anticonvulsant was discontinued, the signs and symptoms improved and the patient was discharged. Early recognition of drug-induced hepatitisis essential, as delay in diagnosis and with drawal of the suspected triggering drug may result in increased mortality.

Keywords:acutehepatites;anticonvulsant; pharmacovigilance; adverse drugreaction.