Effect of Diphenylhydatoin Therapy on Folate Metabolism of Mentally Retarded Epileptics

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Either a rise or fall in serum folate levels was observed in mentally retarded epileptics with diphenylhydantoin therapy. Urinary excretion of FIGLU after an oral histidine load was decreased sienificantly in patients with the anticonvulsant therapy. Eleven cases out of 37 cases with diphenvlhvdantoin administration showed aa positive ferric chloride reaction of urine collected after an oral histidine load. The positive ferric chloride reaction was proved to be due to the presence of imidazole pyruvic acid, suggesting a defective activity of the hepatic histidase of epileptics with the drug therapy. Tt was suygested that the decreased urinary FIGLU during the drug therapy might be partly resulted from a defective activity of the hepatic histidase which was caused by diphenylhydantoin therapy. Serum vitamin B₁₂ levels, MCV and an incidence of hyPersegmentation of neutrophil nuclei showed no difference between patients with diphenylhydantoin therapy and those without it.