Megaloblastic Anaemia Following Anticonvulsants

Berlyne, N.; Levene, Michelle; Mcglashan, Alan

doi:10.1136/bmj.1.4924.1247

Cited by 30 publications

(6 citation statements)

References 5 publications

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“…antd tile Royal Infirmnary of Edinbutrgh In 1954 Badenoch described the cases of two epileptic patients who developed megaloblastic anaemia while tinder treatment with phenytoin sodium, and subsequently 10 further such cases were recorded (Hawkins and Meynell, 1954;Chalmers and Boheimer, 1954;Rhind and Varadi, 1954;Webster, 1954;Berlyne et al, 1955;Ryan and Forshaw, 1955). All the patients had received phenytoin sodium; in all but one instance, where no mention is made of the fact, phenobarbitone had been given in addition, and sometimes other anticonvulsant drugs had supplemented therapy.…”

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confidence: 99%

“…All the patients had received phenytoin sodium; in all but one instance, where no mention is made of the fact, phenobarbitone had been given in addition, and sometimes other anticonvulsant drugs had supplemented therapy. In two instances primidone was given in addition to the phenytoin sodium and phenobarbitone (Chalmers and Boheimer, 1954;Berlyne et al, 1955).…”

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confidence: 99%

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Megaloblastic Anaemia Occurring During Primidone Therapy

Girdwood¹,

Lenman²

1956

BMJ

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confidence: 99%

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confidence: 99%

Megaloblastic Anaemia Occurring During Primidone Therapy

Girdwood¹,

Lenman²

1956

BMJ

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“…It appears to require longcontinued use of the drugs (Badenoch, 1954;Berlyne et al, 1955)-as was the case here. As can be seen from the fundus photographs, with treatment of the anaemia the haemorrhages in the left eye cleared rapidly, with restoration of the visual acuity ( Figs.…”

Section: Discussionmentioning

confidence: 61%

Case of tuberous sclerosis and haemorrhagic retinophathy (with fundus photographs)

Dyer¹,

Hill²,

Rowan³

et al. 1967

BMJ

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“…Rhind and Varadi's (1954) and Webster's (1954) papers both dealt with megaloblastic anaemia after phenytoin sodium, the former's patients responding to folic acid, and Webster's case being successfully treated with vitamin Bl2. Berlyne, Levene, and McGlashan (1955) published the histories of two epileptics developing megaloblastic anaemia, the first after taking phenytoin sodium and phenobarbitone, and the second after taking primidone for three months in addition to phenytoin sodium and phenobarbitone which had been prescribed over four years. The patients did well on folic acid.…”

Section: Discussionmentioning

confidence: 99%

Observations on Megaloblastic Anaemias After Primidone

Fuld¹,

Moorhouse²

1956

BMJ

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DiscussionAlthough mid-diastolic apical murmurs may be heard in cases of anomalous pulmonary venous drainage (Gardner and Oram, 1953; Whitaker, 1954), a confident diagnosis of mitral stenosis was made in this patient because of the presence of an enlarged left atrium fluoroscopically, and a well-marked opening snap clinically. In view of the grave condition of the patient it was decided to perform a mitral valvotomy before undertaking any special investigations such as cardiac catheterization. The findings at subsequent cardiac catheterization confirmed the presence of partial anomalous pulmonary venous drainage into the right atrium via the superior vena cava.In a patient with mitral stenosis the presence of anomalous pulmonary venous drainage would probably add to the disability by increasing the pulmonary artery pressure. Relief of the mitral stenosis would be expected to result in improvement in the patient's condition, though perhaps not to the same extent as in a patient with normal pulmonary venous drainage. The result in this case has been excellent and most gratifying.Taussig (1947), Snellen and Albers (1952), and Whitaker (1954) noted that the typical " figure-of-8 " or " cottageloaf" cardiovascular shadow was diagnostic of total anomalous pulmonary venous drainage into a left superior vena cava. Grishman et al. (1951) reported a case of partial anomalous pulmonary venous drainage, and the teleradiogram reproduced in their report showed the typical " figureof-8" appearance. However, as the difference in oxygen content between blood from the right atrium and the femoral artery was only 0.5 vol. %, which might be within the range of experimental error, it is possible that their patient in fact had total pulmonary venous drainage into a left superior vena cava. The normal arterial oxygen saturation in their patient would not exclude this possibility, as a similar finding was noted in a proved case by Gardner and Oram (1953). In the case reported here, although only part of the venous drainage of the lungs was into the left superior vena cava, the typical " cottage-loaf " cardiovascular shadow was present and was explained by the additional presence of tricuspid incompetence with subsequent increased prominence of the superior vena caval shadow. Summary A case is reported of the association of mitral stenosis and partial anomalous pulmonary venous drainage into a left superior vena cava. An excellent result was obtained by mitral valvotomy.The radiological appearance was suggestive of total drainage of pulmonary veins into a left superior vena cava, and was explained by the additional presence of tricuspid incompetence. I thank Dr. K. Shirley Smith, in whose department the cardiac catheterization was performed, and Mr. J. R. Belcher for permission to record this case.

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Megaloblastic Anaemia Following Anticonvulsants

Cited by 30 publications

References 5 publications

Megaloblastic Anaemia Occurring During Primidone Therapy

Megaloblastic Anaemia Occurring During Primidone Therapy

Case of tuberous sclerosis and haemorrhagic retinophathy (with fundus photographs)

Observations on Megaloblastic Anaemias After Primidone

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