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February 12, 1955


JAMA. 1955;157(7):613. doi:10.1001/jama.1955.02950240051022

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To the Editor:—  The nephrotoxic effect of N-methyl-α-phenylsuccinimide (Milontin), a succinimide compound recently introduced for the treatment of petit mal, has been noted by four different observers. Microscopic hematuria and granular casts were observed in 10 children whose urine showed no abnormality before treatment (Millichap, J. G.: Lancet2:907 [Nov. 8] 1952). In four of these patients frequency of micturition or enuresis developed. The degree of toxicity of the drug was related to the dose; when less than 2.7 gm. was given daily, the effect was minimal and transient, while the effect produced by 2.7 and 4.8 gm., respectively, per day in two patients necessitated withdrawal of the medicament. That hematuria is a toxic effect of N-methyl-α-phenylsuccinimide has since been confirmed by G. A. Thompson (cited by Millichap, J. G., and Kirman, B. H.: Lancet1:1074 [May 30] 1953), by Dora Chao and W. S. Fields (J. Pediat.

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