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June 1989

Reversible Common Variable Immunodeficiency Syndrome Induced by Phenytoin

Author Affiliations

From the Allergy and Immunology Section, Department of Medicine, Lenox Hill Hospital, New York, NY.

Arch Intern Med. 1989;149(6):1421-1422. doi:10.1001/archinte.1989.00390060133029

• Phenytoin-induced panhypogammaglobulinemia mimicking the common variable immunodeficiency syndrome is rare. We describe a patient who, while being treated with phenytoin and corticosteroids, developed panhypogammaglobulinemia, recurrent pneumonia, eosinophilia, and a transient rash. Immunoglobulin levels, which had been normal prior to phenytoin therapy, returned to normal over a period of several months after the drug therapy was stopped. Levels of IgG subclasses and numbers of B cells, T cells, and T-cell subsets were determined during the recovery period. In a review of the reported cases, eosinophilia and rashes were frequently noted. These findings, along with recurrent infections in a patient receiving phenytoin therapy, should prompt a careful evaluation of the patient's immunologic status.

(Arch Intern Med. 1989;149:1421-1422)

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