CYP2C19遺伝子多型によるフェニトイン中毒の脳卒中片麻痺の1例  [in Japanese] A Case Report of a Phenytoin Toxic Stroke Patient with Genetic CYP2C19 Polymorphism  [in Japanese]

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Author(s)

    • 桐野 友子 KIRINO Tomoko
    • 鹿児島大学大学院医歯学総合研究科運動機能修復学講座リハビリテーション医学 Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University
    • 緒方 敦子 OGATA Atsuko
    • 鹿児島大学大学院医歯学総合研究科運動機能修復学講座リハビリテーション医学 Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University
    • 下堂薗 恵 [他] SHIMODOZONO Megumi
    • 鹿児島大学大学院医歯学総合研究科運動機能修復学講座リハビリテーション医学 Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University
    • 野元 佳子 NOMOTO Yoshiko
    • 鹿児島大学大学院医歯学総合研究科運動機能修復学講座リハビリテーション医学 Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University
    • 川平 和美 KAWAHIRA Kazumi
    • 鹿児島大学大学院医歯学総合研究科運動機能修復学講座リハビリテーション医学 Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University
    • 茂見 茜里 SHIGEMI Akari
    • 鹿児島大学病院霧島リハビリテーションセンター薬剤部 Department of Hospital Pharmacy, Kirishima Rehabilitation Center, Kagoshima University Hospital

Abstract

Genetic polymorphisms in the cytochrome P450 family are widely known to contribute to inter-individual differences in drug pharmacokinetics. In this study we report a case of a patient with cytochrome P450 2C19 polymorphism. A 57-year-old woman presented with right cerebral hemorrhage and left hemiplegia. She was administrated phenytoin (200 mg/day)and phenobarbital (60 mg/day) to prevent convulsions. After a change in phenytoin dosage (97% grains to 10% grains), she developed ataxia and experienced a disturbance in her activities of daily living. She was admitted to our hospital. Her serum concentration of phenytoin was found to be at a toxic level (45.9μg/ml) and serum phenobarbital was relatively high (19.1μg/ml). She showed an extremely low clearance of phenytoin, so we checked the genotype of her P450 2C9 and P450 2C19 cytochromes, which are metabolic enzymes of phenytoin. For cytochrome P450 2C9, the patient was a homozygous extensive metabolizer (wild type, *1/*1), but for cytochrome P450 2C19, she was a poor metabolizer (*3/*3). Her phenytoin dosage was reduced, and her ataxia, activities of daily living, left hemiplegia, and cerebral blood flow in Xe-CT improved.

Journal

  • The Japanese Journal of Rehabilitation Medicine

    The Japanese Journal of Rehabilitation Medicine 45(9), 617-622, 2008-09-18

    The Japanese Association of Rehabilitation Medicine

References:  13

Codes

  • NII Article ID (NAID)
    110006935728
  • NII NACSIS-CAT ID (NCID)
    AN00250275
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    18813526
  • NDL Article ID
    9660473
  • NDL Source Classification
    ZS35(科学技術--医学--外科学・整形外科学・麻酔学)
  • NDL Call No.
    Z19-283
  • Data Source
    CJP  NDL  NII-ELS  J-STAGE 
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