Hypothyroidism and Phenytoin Intoxication

Abstract

Brief Reports1 March 1985Hypothyroidism and Phenytoin IntoxicationMOSHE KUSHNIR, M.D., RUTH WEINSTEIN, M.D., BARUCH LANDAU, M.D., GABRIEL SHAVIT, M.Sc., MARCO BECHAR, M.D., NATAN GADOTH, M.D.MOSHE KUSHNIR, M.D.Search for more papers by this author, RUTH WEINSTEIN, M.D.Search for more papers by this author, BARUCH LANDAU, M.D.Search for more papers by this author, GABRIEL SHAVIT, M.Sc.Search for more papers by this author, MARCO BECHAR, M.D.Search for more papers by this author, NATAN GADOTH, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-3-341 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAdministration 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...References1. LIEWENDAHL K, MAJURI H, and HELENIUS T. Thyroid function tests in patients on long-term treatment with various anti-convulsant drugs. Clin Endocrinol. 1978;8:185-91. CrossrefMedlineGoogle Scholar2. KUIPER J. Lymphocytic thyroiditis possibly induced by diphenylhydantoin. JAMA. 1969;210:2370-2. CrossrefMedlineGoogle Scholar3. NISHIYAMA S, MATSUKURA M, FUJIMOTO S, and MATSUDA I. Reports of two cases of autoimmune thyroiditis while receiving anticonvulsant therapy. Eur J Pediatr. 1983;140:116-7. CrossrefMedlineGoogle Scholar4. WILDER B, RAMSEY R, WILLMORE L, FEUSSNER G, PERCHALSKI R, and SHUMATE J. Efficacy of intravenous phenytoin in the treatment of status epilepticus: kinetics of central nervous system penetration. Ann Neurol. 1977;1:511-8. CrossrefMedlineGoogle Scholar5. HOCH F, DEPIERRE W, and ERNSTER L. Thyroid control over biomembranes: liver-microsomal cytochrome b5 in hypothyroidism. Eur J Biochem. 1980;109:301-6. CrossrefMedlineGoogle Scholar6. BLACKSHEAR J, SCHULTZ A, NAPIER J, and STUART D. Thyroxine replacement requirements in hypothyroid patients receiving phenytoin. Ann Intern Med. 1983;99:341-2. LinkGoogle Scholar7. OPPENHEIMER J and TAVERNETTI R. Displacement of thyroxine from human thyroxine-binding globulin by analogues of hydantoin: steric aspects of the thyroxine binding site. J Clin Invest. 1962;41:2213-20. CrossrefMedlineGoogle Scholar8. LIEWENDAHL K and MAJURI H. Thyroxine, triiodothyronine and thyrotropin in serum during long-term diphenylhydantoin therapy. Scand J Clin Lab Invest. 1976;36:141-4. CrossrefMedlineGoogle Scholar9. FINUCANE J and GRIFFITHS R. Effect of phenytoin therapy on thyroid function. Br J Clin Pharmacol. 1976;3:1041-4. CrossrefMedlineGoogle Scholar10. MOLHOLM-HANSEN J, SKOVSTED L, BIRK-LAURIDSEN U, KIRKEGAARD C, and SIERSBAEK-NIELSEN K. The effect of diphenylhydantoin on thyroid function. J Clin Endocrinol Metab. 1974;39:785-9. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: MOSHE KUSHNIR, M.D.; RUTH WEINSTEIN, M.D.; BARUCH LANDAU, M.D.; GABRIEL SHAVIT, M.Sc.; MARCO BECHAR, M.D.; NATAN GADOTH, M.D.Affiliations: Beilinson Medical Center Petach Tiqva Israel The Sackler School of Medicine Tel Aviv University Tel Aviv Israel PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byGuidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone ReplacementThyroid disease and the nervous systemSeizures and General Medical DisordersHypothyroxinemia and Phenytoin Toxicity: A Vicious CircleThyroid Status of Patients Receiving Long-Term Anticonvulsant Therapy Assessed by Peripheral Parameters: A Placebo-Controlled Thyroxine Therapy TrialOtolaryngologic manifestations of phenytoin toxicityThyroid DisordersClinical Features and Management of Poisoning Due to PhenytoinIodinated Glycerol-Induced HypothyroidismThyroid dysfunction during chronic amiodarone therapyGrades 1 and 2 hypothyroidism in a state mental hospital: Risk factors and clinical findingsReferencesAnticonvulsant drugsHypothyroidism and Phenytoin IntoxicationJAMES P. FINNERTY, M.R.C.P.Hypothyroidism and PhenytoinMARTIN I. SURKS, M.D. 1 March 1985Volume 102, Issue 3 Page: 341-342 Keywords Anticonvulsants Epilepsy Hospitalizations Hypothyroidism Intoxication Neurology Thyroid Thyroid hormones ePublished: 1 December 2008 Issue Published: 1 March 1985 PDF downloadLoading ...