A 33 year old epiletic male was treated with 0.2-0.3g per day of diphenylhydantion for about 18 months till his death. Post-mortem examination was performed about 6 hours after death. The pathoanatomical findings were 1. (epilepsy), 2, hypostatic pneumonia, 3. congestion (liver, spleen, kidneyes), 4, atrophy (hypophysis, thyroid gland, parathyroid glands, adrenal glands, testes), 5. gingival hyperplasia.
Histologically, there were a widespreading loss of Purkinje's cells in the cerebellum, slight atrophy of the nerve cells in the cerebral cortex, non-specific atrophy of the endocrine glands above mentioned, and resorptions of the skeleton (parietal bone, sternum, rib, femur). Congestive edema was a prominent feature in the gingivae, periodotal membranes, and bone marrows of the jaw bones. Inflammatory infiltration was relatively slight and limited in the superficial part of the hyperplastic gingivae. Diffuse resorptions were found in the jaw bones, and in the alveolar bones the vertical type of resorption was conspicuous. There could be seen severe atrophies in the submandibular, slight ones in the sublingual, palatine and lingual, and no remarkable changes in the other salivary glands. There were some erosions of tongue, but no inflammations of the mucous membranes of palatine, pharynx, oesophagus, stomach, and intestines.
These pathological findings suggest that the oral tissue changes in this case might be composed of congestive edema of the mucous membane and bone resorption resulting from the disturbances of endorine functions caused by chronic diphenylhydantoin intoxication.