Lymphoproliferative disorders in four patients receiving chronic diphenylhydantoin therapy: etiologic correlation or chance association?

The occurrence of angioimmunoblastic lymphadenopathy, Hodgkin's disease or IgG-lambda multiple myeloma is described in four patients receiving chronic diphenylhydantoin (DILANTIN) therapy. Although the association between diphenylhydantoin therapy and the development of immunosuppression and lymphoma is well documented, the role of the drug in the etiology of these disorders is still controversial. It is suggested that periodic examination of patients receiving diphenylhydantoin for lymphadenopathy and repeated serum electrophoresis may be useful in detecting early aberrations of the immune system in these individuals.