Cholestatic liver dysfunction after long-term phenytoin therapy
J. W. Taylor, M. N. Stein, M. J. Murphy and F. A. Mitros
Cholestatic jaundice developed in a 64-year-old woman who had received
phenytoin sodium for more than 40 years. Discontinuation of phenytoin
therapy resulted in resolution of the hepatic abnormalities, which recurred
on rechallenge, strongly suggesting a causal relation to the drug.
Phenytoin therapy was discontinued again, with complete resolution of the
hepatic abnormalities. The liver biopsy specimen obtained during therapy
showed cholestasis compatible with obstruction of the biliary tree,
although an obstructive process was never demonstrated. The biochemical
abnormalities and histologic features observed most likely represent an
unusual response to phenytoin therapy.