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Hypothyroidism and Phenytoin Intoxication

MOSHE KUSHNIR, M.D.; RUTH WEINSTEIN, M.D.; BARUCH LANDAU, M.D.; GABRIEL SHAVIT, M.Sc.; MARCO BECHAR, M.D.; and NATAN GADOTH, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Natan Gadoth, M.D.; Department of Neurology, Beilinson Medical Center; Petach Tiqva, 49 100 Israel.


Beilinson Medical Center, Petach Tiqva, Israel; and The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel


Ann Intern Med. 1985;102(3):341-342. doi:10.7326/0003-4819-102-3-341
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Administration of phenytoin may be associated with decreased serum levels of various thyroid hormones although the patients are clinically euthyroid and their thyrotrophin levels normal (1). Only rarely is phenytoin in combination with other anticonvulsants related to clinical hypothyroidism, probably by inducing autoimmune thyroiditis (2, 3). We report the case of an epileptic woman in whom severe hypothyroidism concomitant with phenytoin intoxication appeared when she was on long-term phenytoin maintenance.

A 70-year-old woman who had had epilepsy for 6 years was being treated with phenytoin, 100 mg three times a day. Two months before hospitalization she began having progressive disorientation

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