Purple glove syndrome caused by oral administration of phenytoin

Abstract

A severely handicapped boy had been treated with phenytoin and his seizures were controlled well. At 10 years of age, a pharmacy gave about 1000 mg of phenytoin instead of the prescribed 100 mg of the drug per day. Several hours after the initial administration, the patient became drowsy and his hands and feet turned dark purple with marked swelling. Four days later, his mother stopped administering the phenytoin to him and took him to hospital. After fluid therapy was started, the swelling and discoloration of both his hands and feet improved gradually and disappeared 11 days after drug discontinuation. Purple glove syndrome is defined as the edema, discoloration, and pain occurring in the distal limb where intravenous phenytoin has been administered. This might be the first report of purple glove syndrome caused by the oral administration of a large quantity of phenytoin.