Aplasia of the Bone Marrow During Mesantoin® Therapy

Mesantoin® (3-methyl-5,5 phenylethyl hydantoin) has received widespread acclaim as an anticonvulsant drug particularly useful in convulsive states of the grand mal and psychomotor types.1The early investigators reported few toxic manifestations of the drug.2However, since 1946, several severe hematological reactions with recovery3and six cases which terminated fatally4have appeared in the literature. Trimethadione (tridione®) as well as mesantoin®, was implicated in the fatality reported by Harrison, Johnson and Ayer.4c The object of this paper is to report a fatal case of aplasia of the bone marrow directly attributable to mesantoin® idiosyncrasy and to review the toxic manifestations of this relatively new and valuable anticonvulsant preparation. REPORT OF CASE Mrs. A. V., a 35-yr.-old white woman, was admitted to the medical service of the Newark City Hospital complaining of sudden onset of nonmigratory joint pains of two days' duration involving the ankles and knees.