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Transient antibody deficiency and abnormal t-suppressor cells induced by phenytoin


The lack of normal  B-cell  differentiation in patients with acquired or congenital antibody  deficiency may reflect abnormalities inherent in cells of B-lymphoid  lineage or may  involve abnormalities of regulatory (suppressor) cells. Circulating suppressor T cells,  which interfere with IgM secretion in a plaque-forming-cell assay,
have been found in 60 per cent of these patients,  but their role in the pathogenesis of the disease is unclear.  We observed the development of abnormal suppressor T cells and hypogammaglobulinemia in a patient receiving phenytoin (diphenylhydantoin). After the drug was withdrawn, the suppressor activity disappeared and immunoglobulin production resumed. This transient, drug-dependent expression of both suppressor-cell activity and antibody deficiency strengthens the argument that both events may be causally related.

Dosch HM, Jason J, Gelfand EW

N. Engl. J. Med. 1982 Feb;306(7):406-9

PMID: 6460185