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February 1963

Trimethadione Nephrosis

Author Affiliations

Lucius F. Sinks, M.D., Children's Hospital, 561 S. 17th St., Columbus 5, Ohio.; Pediatric Department, 48th Tactical Hospital.

Am J Dis Child. 1963;105(2):196-198. doi:10.1001/archpedi.1963.02080040198011

Introduction  The nephrotoxic effects of the oxazolidine-2,4-diones 1 (trimethadione and paramethadione) have been reported in approximately 11 cases.2 The first such case was in 1948.3 The following case most certainly represents another instance of the nephrotic syndrome secondary to administration of one of these oxazolidine-2,4-diones.

Background  The nephrotic syndrome associated with oxazolidine toxicity has varied somewhat; however, in all cases there has been a generalized anasarca, proteinuria, hyperlipemia, and hypoproteinemia. Many of the cases have had the additional urinary microscopic findings of red blood cells and red blood cell casts, as well as granular casts.4-6 In some cases such tests of renal function as phenolsulfonphthalein excretion and urea clearance have been normal.1,3,7Heymann 2 administered trimethadione to 22 rats. Some of these developed a nephrotic-like syndrome without impressive anasarca and without red blood cells in the urine; however, all the animals (when killed) revealed pathological changes