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Journal of Neurology

, Volume 226, Issue 1, pp 53–61 | Cite as

The reversibility of phenytoin-induced IgA deficiency

  • N. E. Gilhus
  • J. A. Aarli
Original Investigations

Summary

Phenytoin has been shown to induce serum IgA deficiency in patients with epilepsy. We have followed 37 phenytoin-treated patients with reduced serum IgA concentrations for 2–7 years. All anti-epileptic drug treatment was withdrawn in 8 patients. Phenytoin was substituted by other anti-epileptic drugs in 13 patients. Sixteen patients received phenytoin unchanged. The mean serum IgA concentration increased from 0.14 g/l to 0.71 g/l in the patients off drug treatment, and from 0.20 g/l to 0.84 g/l in the patients changing to other drugs. The mean IgA concentration increased from 0.21 g/l to 0.37 g/l in the patients with phenytoin unchanged, due to the increase of the IgA levels in a few patients who initially showed a slightly depressed IgA concentration. The overall increase of IgA concentrations was significant. When tested separately in each patient group, the difference was significant for the patients off all drugs, and for those changing from phenytoin to other drugs. The IgM concentration increased significantly when all patients were considered together. This was due to the increase of IgM in the patients no longer receiving phenytoin therapy. Withdrawal of phenytoin did not influence the IgG concentrations.

Key words

Epilepsy Phenytoin IgA IgG IgM 

Zusammenfassung

Die Therapie mit Phenytoin kann bei Epileptikern zu einem IgA-Defizit führen. Über einen Zeitraum von 2–7 Jahren haben wir 37 mit Phenytoin behandelte Patienten mit einer erniedrigten Serum-IgA-Konzentration beobachtet. Bei 8 Patienten wurde jegliche antiepileptische Therapie eingestellt, bei 13 wurde Phenytoin durch andere Antiepileptika ersetzt, und bei 16 Patienten wurde die Phenytoin-Medikation unverändert beibehalten. Die durchschnittliche IgA-Serumkonzentration stieg von 0,14 g/l auf 0,71 g/l in der Gruppe ohne jegliche antiepileptische Behandlung und von 0,20 g/l auf 0,84 g/l in der Gruppe, die auf andere Antiepileptika eingestellt wurde. Bei der Gruppe mit unveränderter Phenytoin-Medikation stieg die IgA-Konzentration von 0,21 g/l auf 0,37 g/l, bedingt durch die Normalisierung des IgA-Niveaus bei einigen wenigen Patienten mit zuvor nur leicht erniedrigter IgA-Konzentration. Der Anstieg der Serumkonzentration des IgA war signifikant. Ebenfalls als signifikant erwies sich der Unterschied zwischen den Patienten ohne Phenytoin-Therapie und denen, die dieses Medikament weiter einnahmen. Bei der zusammenfassenden Betrachtung aller Patienten zeigt sich ein signifikanter Anstieg der IgM-Konzentration, der sich aus dem Anstieg bei den beiden Patientengruppen ohne Phenytoin-Therapie erklärt. Die IgG-Konzentration wurde durch eine Beendigung der Phenytoin-Therapie nicht beeinflußt.

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Copyright information

© Springer-Verlag 1981

Authors and Affiliations

  • N. E. Gilhus
    • 1
  • J. A. Aarli
    • 1
  1. 1.Department of NeurologyUniversity of BergenBergenNorway

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