{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T20:53:15Z","timestamp":1772916795521,"version":"3.50.1"},"reference-count":13,"publisher":"American Association of Psychiatric Pharmacists (AAPP)","issue":"4","license":[{"start":{"date-parts":[[2019,9,24]],"date-time":"2019-09-24T00:00:00Z","timestamp":1569283200000},"content-version":"vor","delay-in-days":450,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background:<\/jats:title>\n                  <jats:p>Liver fibrosis results from chronic damage to the liver. Advanced liver fibrosis results in cirrhosis, liver failure, and portal hypertension and may even require liver transplantation. A liver biopsy is considered the \u201cgold standard\u201d method for the assessment of liver fibrosis; however, ultrasonography can also detect changes in the hepatic parenchyma due to fibrosis. Although reports in the literature describe phenytoin-induced hepatic injury, often this rare occurrence is usually accompanied by a hypersensitivity reaction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case report:<\/jats:title>\n                  <jats:p>Our patient is a 50-year-old female with history of schizoaffective disorder, bipolar type, who had been admitted to a state psychiatric facility. She has a history of seizure disorder, which had been well controlled with phenytoin since 2011. Mild-to-moderate elevations in her liver enzymes were noted during therapy but normalized once phenytoin was discontinued. An ultrasound of the patient's liver in January 2016 showed changes of fatty infiltration and fibrosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>This case differs from other cases reported in the literature that describe phenytoin-induced hepatic injury. The majority of these cases are accompanied by immune-allergic features. To our knowledge, there have been no reported cases in the literature of prolonged liver enzyme elevation resulting in phenytoin-induced hepatic fibrosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.9740\/mhc.2018.07.184","type":"journal-article","created":{"date-parts":[[2018,7,6]],"date-time":"2018-07-06T18:49:32Z","timestamp":1530902972000},"page":"184-187","source":"Crossref","is-referenced-by-count":10,"title":["Phenytoin-induced chronic liver enzyme elevation and hepatic fibrosis: A case report"],"prefix":"10.9740","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9923-1882","authenticated-orcid":false,"given":"Brent","family":"Curry","sequence":"first","affiliation":[{"name":"(Corresponding author) Clinical Psychiatric Pharmacist, Central State Hospital, Louisville, Kentucky, brent.curry@ky.gov"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2852-6632","authenticated-orcid":false,"given":"Lisa","family":"Mican","sequence":"additional","affiliation":[{"name":"Assistant Director of Pharmacy, Austin State Hospital, Austin, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7512-4919","authenticated-orcid":false,"given":"Tawny L.","family":"Smith","sequence":"additional","affiliation":[{"name":"Associate Professor of Psychiatry, Dell Medical School, The University of Texas at Austin, Austin, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4719","reference":[{"issue":"2","key":"2020060307274417700_i2168-9709-8-4-184-b01","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1172\/JCI24282","article-title":"Liver fibrosis","volume":"115","author":"Bataller","year":"2005","journal-title":"J Clin Invest"},{"issue":"6","key":"2020060307274417700_i2168-9709-8-4-184-b02","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1111\/j.1572-0241.2004.30110.x","article-title":"Evaluation of liver fibrosis: a concise review","volume":"99","author":"Afdhal","year":"2004","journal-title":"Am J Gastroenterol"},{"key":"2020060307274417700_i2168-9709-8-4-184-b03","article-title":"National Institutes of Health","author":"Phenytoin [Internet]","year":"2017","journal-title":"US Department of Health and Human Services;"},{"issue":"4","key":"2020060307274417700_i2168-9709-8-4-184-b04","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1093\/ajcp\/74.4.442","article-title":"Hepatic injury associated with diphenylhydantoin therapy. 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