The occurrence of "sore mouth" as a frequent complication in the treatment of epilepsy with dilantin sodium (sodium diphenylhydantoinate) was first reported by Kimball1 in 1939. Of 152 patients under treatment for from two to eleven months, 57 per cent showed changes in the gingival tissue, varying from slight to extreme hyperplasia. The changes were not proportionate to the amount of dilantin sodium ingested or to the length of time the patient had been taking the drug. As the appearance of the gingival tissues suggested scurvy (all other signs, such as purpura and sore joints, were absent), the ascorbic acid content of the blood serum was determined in a number of cases. From these serum analyses Kimball concluded that the degree of hyperplasia directly paralleled the deficiency of ascorbic acid. That is, persons with the most marked hyperplasia showed the lowest level of ascorbic acid, which dropped to 0.1
ZISKIN DE, STOWE LR, ZEGARELLI EV. DILANTIN HYPERPLASTIC GINGIVITIS: ITS TREATMENT AND PREVENTION. Arch NeurPsych. 1941;46(5):897–907. doi:10.1001/archneurpsyc.1941.02280230139010
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