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To the Editor:—
The case report may be of significant interest to merit further investigation, or may present misleading information to physicians who are not familiar with the current use of this drug in cardiac arrhythmias. The authors report on the possible toxicity of a drug in which the definite therapeutic dosage, intravenously, has not yet been established. They fail to report the dosage of diphenylhydantoin given, the rate of infusion, how long after beginning the infusion the arrhythmia occurred, or the protein bound iodine level just before or after the arrhythmia was observed.What the four authors of this short article do report is a possible sudden release of bound levothyroxine in a patient who is receiving (purposely) subtherapeutic amounts of this drug.
Gaspar HL. Diphenylhydantoin And Arrhythmia. JAMA. 1966;197(1):63. doi:10.1001/jama.1966.03110010115041