Therapeutic Drug Monitoring 1980
Increased clearance of phenytoin as the presenting feature of infectious mononucleosis.
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Abstract
A 19-year-old man with posttraumatic seizures under good control with phenytoin, 500 mg/day, presented with three seizures. His blood level of phenytoin, previously in a therapeutic range, was 4.2 microgram/ml. No systemic or laboratory evidence of infectious mononucleosis was found. Ten days later, the blood picture became compatible with infectious mononucleosis, at which time his phenytoin clearance returned to normal.
