Early-onset phenytoin toxicity mimicking a renopulmonary syndrome

Phenytoin is a commonly used anti-epileptic drug, Adverse reactions including fever, skin reactions and lymphadenopathy are well known but atypical reactions can also occur. A patient is described with a lag time of only 4 days between onset of phenytoin and the development of a syndrome with acute lung injury and renal failure, The symptoms mimicked a renopulmonary syndrome, and resolved completely after cessation of phenytoin and addition of steroids.