International Journal of Contemporary Medicine

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A Study of effect of Phenytoin on Liver Enzymes in Epileptic Patients in Western Uttar Pradesh


Affiliations
1 Department of Pharmacology, Saraswathi Institute of Medical Sciences Hapur, U.P., India
2 Department of Biochemistry, Saraswathi Institute of Medical Sciences Hapur, U.P., India
     

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Aim & Objective: In this study, we investigated the effects of phenytoin on hepatic enzyme levels in epileptic patients.

Method: In this prospective clinical study, we measured the serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT) on 120 epiteptic patients. consecutive admissions to our epilepsy unit.

Result: Serum gamma glutamyl transferase (gammaGT), AST, ALT activities have been estimated in 120 epileptic patients taking Phenytoin as anticonvulsant drugs. Serum AST, ALT & GGT levels were increased.

Conclusion: We found most of our patients on Phenytoin had an elevated serum concentration of GGT, which is consistent with previous reports. AST and ALT were also elevated in these patients and therefore suggested the increased GGT was due to enzyme induction. Elevation of GGT needs to be considered differently in light of the use of new antiepileptic medications.


Keywords

Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Gamma-glutamyl Transpeptidase (GGT), Metabolic Abnormalities, Phenytoin (PHT).
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  • Zimmerman HJ. Anticonvulsants. In, Zimmerman, HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott, 1999: pp.498-516.

  • Pirmohamed M, Leeder SJ. Anticonvulsant agents. In, Kaplowitz N, DeLeve LD, eds. Druginduced liver disease. 2nd ed. New York: Informa Healthcare USA, 2007: pp 485-506.

  • McNamara JO. Pharmacology of the epilepsies. In, Brunton LL, Lazo JS, Parker KL, eds. Goodman & Gilman’s the pharmacological basis of therapeutics. 11th ed. New York: McGraw-Hill, 2006, pp. 501-525.

  • Kazamatsuri H. Elevated serum alkaline phosphatase levels in epilepsy during diphenyldantoin therapy. N Engl J Med 1970; 283: 1411-1412.

  • Pezzimenti FJ, Hahn AL. Anicteric hepatitis induced by diphenylhydantoin. Arch Intern Med 1970; 125: 118-120.

  • Anthony J. Malignant lymphoma associated with hydantoin drugs. Arch Neurol 1970; 22: 450-4.

  • Andreasen PB, Lyngbye J, Trolle E. Abnormalities in liver function tests during long-term diphenylhydantoin therapy in epileptic outpatients. Acta Med Scand 1973; 194: 261-4.

  • Jerina DM, Daly JW. Arene oxides: a new aspect of drug metabolism. Science 1974; 185: 573-82.

  • Dhar GJ, Ahamed PN, Pierach CA, Howard RB. Diphenylhydantoin-induced hepatic necrosis. Postgrad Med 1974; 56: 128-134.

  • Weedon AP. Diphenylhydantoin sensitivity. A syndrome resembling infectious mononucleosis with a morbilliform rash and cholestatic hepatitis. Aust NZ J Med 1975; 5: 561-563.

  • Kleckner HB, Yakulis V, Heller P. Severe hypersensitivity to diphenylhydantoin with circulating antibodies to the drug. Ann Intern Med 1975; 83: 522-523.

  • Lee TJ, Carney CN, Lapis JL, Higgins T, Fallon HJ. Diphenylhydantoin-induced hepatic necrosis. A case study. Gastroenterology 1976; 70: 422-4.

  • Lapes MJ, Vivacqua RJ, Antoniades K. Immunoblastic lymphadenopathy associated with phenytoin(diphenylhydantoin). Lancet 1976; 1: 198

  • Jacobsen NO, Mosekilde L, Myhre-Jensen O, Pedersen E, Wildenhoff KE. Liver biopsies in epileptics during anticonvulsant therapy. Acta Med Scand 1976; 199: 345-8.

  • Charlesworth EN. Phenytoin-induced pseudolymphoma syndrome. An immunologic study. Arch Derm 1977; 113: 477-80.

  • Campbell CB, McGuffie C, Weedon AP, Powell LW. Cholestatic liver disease associated with diphenylhydantoin therapy. Possible pathogenic importance of altered bile salt metabolism. Am J Dig Dis 1977; 22: 255-62

  • ]Parker WA, Shearer CA. Phenytoin hepatotoxicity: a case report and review. Neurology 1979; 29: 175-7.

  • Haruda F. Phenytoin hypersensitivity. Thirtyeight cases. Neurology 1979; 29: 1480-5

  • Mullick FG, Ishak KG. Hepatic injury associated with diphenylhydantoin therapy: a clinicopathologic study of 20 cases. Am J Clin Pathol 1980; 74: 442-52.

  • Aiges HW, Daum F, Olson M, Kahn E, Teichberg S. The effects of phenobarbital and diphenylhydantoin on liver function and morphology. J Pediatr 1980; 97: 22-6.

  • Spielberg SP, Gordeon GB, Blake DA, Goldstein DA, Herlong HFl. Predisposition to phenytoin hepatotoxicity assessed in vitro. N Engl J Med 1981; 305: 722-7

  • Cook IF, Shilkin KB, Reed WD. Phenytoin induced granulomatous hepatitis. Aust NZ J Med 1981; 11: 539-41.

  • Spechler SJ, Sperber H, Doos WG, Koff RS. Cholestasis and toxic epidermal necrolysis associated with phenytoin sodium ingestion: the role of bile duct injury. Ann Intern Med 1981; 95: 455-6.


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  • A Study of effect of Phenytoin on Liver Enzymes in Epileptic Patients in Western Uttar Pradesh

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Authors

Harsh Misra
Department of Pharmacology, Saraswathi Institute of Medical Sciences Hapur, U.P., India
Sunita Singh
Department of Pharmacology, Saraswathi Institute of Medical Sciences Hapur, U.P., India
Bina Shukla
Department of Pharmacology, Saraswathi Institute of Medical Sciences Hapur, U.P., India
Yogesh Kumar Rai
Department of Biochemistry, Saraswathi Institute of Medical Sciences Hapur, U.P., India

Abstract


Aim & Objective: In this study, we investigated the effects of phenytoin on hepatic enzyme levels in epileptic patients.

Method: In this prospective clinical study, we measured the serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT) on 120 epiteptic patients. consecutive admissions to our epilepsy unit.

Result: Serum gamma glutamyl transferase (gammaGT), AST, ALT activities have been estimated in 120 epileptic patients taking Phenytoin as anticonvulsant drugs. Serum AST, ALT & GGT levels were increased.

Conclusion: We found most of our patients on Phenytoin had an elevated serum concentration of GGT, which is consistent with previous reports. AST and ALT were also elevated in these patients and therefore suggested the increased GGT was due to enzyme induction. Elevation of GGT needs to be considered differently in light of the use of new antiepileptic medications.


Keywords


Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Gamma-glutamyl Transpeptidase (GGT), Metabolic Abnormalities, Phenytoin (PHT).

References