HEN VAI WU, M.D.; MARTIN KOSMIN, M.D.
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To the editor: Bayer (Ann Intern Med 85:475-476, 1976) has described miliary pulmonary infiltrates as a previously unreported manifestation of Dilantin® (phenytoin) toxicity. We recently saw a patient with Dilantin toxicity whom we found to have multiple noncaseating bone-marrow granulomata, which to our knowledge has not been described as a manifestation of this disorder.
The patient, a 34-year-old alcoholic, diabetic, black man was admitted to Middlesex General Hospital, with diarrhea, rash and lymphadenopathy of 1 to 2 weeks duration. Four weeks after Dilantin was started for a seizure disorder. Bone-marrow aspiration and biopsy showed multiple noncaseating granulomata. A bone-marrow specimen
WU HV, KOSMIN M. Bone-Marrow Granulomata And Phenytoin. Ann Intern Med. ;86:663–664. doi: 10.7326/0003-4819-86-5-663_2
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Published: Ann Intern Med. 1977;86(5):663-664.
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