{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T20:40:06Z","timestamp":1780605606644,"version":"3.54.1"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T00:00:00Z","timestamp":1753574400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T00:00:00Z","timestamp":1753574400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medical Case Reports"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Phenytoin is a widely prescribed antiepileptic drug that is associated with various adverse effects, but gastrointestinal manifestations are rare. Therapeutic drug monitoring is essential for ensuring safe and effective dosing by measuring the drug levels in the blood. We present the case of a 65-year-old individual with a history of seizure disorder, hypertension, and stable chronic kidney disease, who presented with acute abdominal distension and constipation. Imaging studies revealed acute colonic pseudo-obstruction, while serum phenytoin levels were elevated at 25.6 \u03bcg\/mL (therapeutic range: 10\u201320 \u00b5g\/mL). The patient\u2019s symptoms resolved following gradual tapering of phenytoin and initiation of levetiracetam over 2 weeks. This case highlights a rare presentation of phenytoin toxicity manifesting as Ogilvie syndrome and underscores the importance of therapeutic drug monitoring and early recognition of gastrointestinal symptoms in patients on phenytoin therapy.<\/jats:p>","DOI":"10.1177\/2050313x251357786","type":"journal-article","created":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T16:36:53Z","timestamp":1753634213000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Phenytoin-induced Ogilvie syndrome: A rare case report"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7094-0167","authenticated-orcid":false,"given":"Joel","family":"Sabu","sequence":"first","affiliation":[{"name":"Internal Medicine, Father Muller Medical College, Mangaluru, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3578-7196","authenticated-orcid":false,"given":"Kevin Jose","family":"Madapat","sequence":"additional","affiliation":[{"name":"JSS College of Pharmacy, Mysuru, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9702-6623","authenticated-orcid":false,"given":"Namitha K.","family":"Baby","sequence":"additional","affiliation":[{"name":"Internal Medicine, Kasturba Medical College, Mangaluru, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,27]]},"reference":[{"issue":"4","key":"e_1_3_3_2_2","first-page":"1697","article-title":"Analysis of phenytoin drug concentration for evaluation of clinical response, uncontrolled seizures and toxicity","volume":"31","author":"Shaikh AS","year":"2018","unstructured":"Shaikh AS, Li Y, Cao L, et al. Analysis of phenytoin drug concentration for evaluation of clinical response, uncontrolled seizures and toxicity. Pak J Pharm Sci 2018; 31(4 special): 1697\u20131700.","journal-title":"Pak J Pharm Sci"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-64189-2.00022-6"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.2131\/jts.43.75"},{"key":"e_1_3_3_5_2","volume-title":"Essentials of medical pharmacology","author":"Tripathi K","year":"2018","unstructured":"Tripathi K. Essentials of medical pharmacology. 8th ed. Jaypee Brothers Medical, 2018.","edition":"8"},{"key":"e_1_3_3_6_2","unstructured":"Iorga A Horowitz BZ. Phenytoin toxicity. In: StatPearls (Internet). Treasure Island (FL): StatPearls Publishing https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482444\/ (2025 updated 8 August 2023)."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12645"},{"issue":"3","key":"e_1_3_3_8_2","article-title":"Phenytoin-induced Ogilvie syndrome: a rare case report","volume":"103","author":"Kayyali R","year":"2024","unstructured":"Kayyali R, Abdulsada M, Yacoub H, et al. Phenytoin-induced Ogilvie syndrome: a rare case report. Medicine 2024; 103(3): e2524.","journal-title":"Medicine"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.5530\/jyp.2015.3.20"},{"issue":"2","key":"e_1_3_3_10_2","article-title":"Clozapine-induced refractory colonic pseudo-obstruction","volume":"16","author":"Siriwardena D","year":"2024","unstructured":"Siriwardena D, Gauci CM, Mohtashami A, et al. Clozapine-induced refractory colonic pseudo-obstruction. Cureus 2024; 16(2): e53377.","journal-title":"Cureus"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviscsurg.2015.02.004"},{"issue":"12","key":"e_1_3_3_12_2","article-title":"Mortality due to complications associated with acute Ogilvie\u2019s syndrome in an older adult treated for psychosis: a case report","volume":"15","author":"Ali MM","year":"2023","unstructured":"Ali MM, Al Saeed M, Ebrahim M, et al. Mortality due to complications associated with acute Ogilvie\u2019s syndrome in an older adult treated for psychosis: a case report. Cureus 2023; 15(12): e51389.","journal-title":"Cureus"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3390\/clinpract15020033"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/MS9.0000000000002524"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"},{"key":"e_1_3_3_16_2","unstructured":"WHO Team Pharmacovigilance (PVG). 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