Toxic Hepatic Necrosis Associated with Taking Dilantin, Tridione and Phenobarbital: Report of a Case

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Abstract
This is a case report of a 52-year-old colored woman, an epileptic, who developed a generalized skin eruption while taking phenobarbital and dilantin. The rash was probably caused by dilantin as it cleared shortly after the drug was stopped. Six mos. after resuming use of dilantin and while also taking phenobarbital and tridione the patient expired from hepatitis. At autopsy the liver was grossly a deep reddish purple, atrophic, and showed many slightly raised greenish irregular small patches of regeneration. On microscopic examination the liver showed disruption of the lobular reticular pattern, evidence of gradual death of liver cells, marked polymorphonuclear cell infiltration, and perisinusoidal edema. These changes are highly suggestive of a toxic etiology. The case is reported in the hope of stimulating exptl. investigation into the hepatotoxic potentialities of dilantin and tridione.