Lithium toxicity. A case report
Introduction Lithium is widely used in the treatment of the bipolar disorder. Once introduced, it is necessary to carry out an adequate control of the therapeutic range, since it is potentially toxic, and can affect various organs. Objectives To present the case of a patient suffering from lithi...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-04-01
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| Series: | European Psychiatry |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933821017284/type/journal_article |
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| author | E. Rodríguez Vázquez C. Capella Meseguer I. Santos Carrasco J. Gonçalves Cerejeira A. Gonzaga Ramírez M. Queipo De Llano De La Viuda G. Guerra Valera C. De Andrés Lobo T. Jiménez Aparicio C. Vallecillo Adame |
| author_facet | E. Rodríguez Vázquez C. Capella Meseguer I. Santos Carrasco J. Gonçalves Cerejeira A. Gonzaga Ramírez M. Queipo De Llano De La Viuda G. Guerra Valera C. De Andrés Lobo T. Jiménez Aparicio C. Vallecillo Adame |
| author_sort | E. Rodríguez Vázquez |
| collection | DOAJ |
| description |
Introduction
Lithium is widely used in the treatment of the bipolar disorder. Once introduced, it is necessary to carry out an adequate control of the therapeutic range, since it is potentially toxic, and can affect various organs.
Objectives
To present the case of a patient suffering from lithium poisoning and to review the symptoms of lithium poisoning.
Methods
A descriptive study of a clinical case and review of the literature
Results
49-year-old woman, married. Diagnosed with bipolar disorder. She went to the emergency room due to a low level of consciousness, kidney failure, trembling of the limbs, hyperthermia and leukocytosis. In the last two weeks, the patient has reduced her intake of food, not water, finding herself more and more shaky and less reactive. Lithium in blood at admission 1.71, so conventional dialysis was performed with a progressive decrease into 0.65. On examination, he is practically mutist, bradypsychia with a significant response latency. Clinical judgment: Accidental lithium poisoning.
Conclusions
The primary site of toxicity is the central nervous system and clinical manifestations vary from asymptomatic supratherapeutic drug concentrations to clinical toxicity such as confusion, ataxia, or seizures. Severe lithium neurotoxicity occurs almost exclusively in the context of chronic therapeutic administration of lithium and rarely results from acute ingestion of lithium, even in patients currently taking lithium. As such it is an iatrogenic illness, occurring in patients who have identifiable clinical risk factors: nephrogenic diabetes insipidus, older age, abnormal thyroid function and impaired renal function.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:38:01Z |
| format | Article |
| id | doaj.art-5b6a071caec1455a8ba191cb2667a56b |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:38:01Z |
| publishDate | 2021-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-5b6a071caec1455a8ba191cb2667a56b2023-11-17T05:09:08ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S651S65110.1192/j.eurpsy.2021.1728Lithium toxicity. A case reportE. Rodríguez Vázquez0C. Capella Meseguer1I. Santos Carrasco2J. Gonçalves Cerejeira3A. Gonzaga Ramírez4M. Queipo De Llano De La Viuda5G. Guerra Valera6C. De Andrés Lobo7T. Jiménez Aparicio8C. Vallecillo Adame9Psiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, SpainPsiquiatría, HCUV, Valladolid, SpainPsiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, SpainPsiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, SpainPsiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, SpainPsiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, SpainPsiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, SpainPsiquiatría, HCUV, Valladolid, SpainPsiquiatría, Hospital Clínico Universitario Valladolid, Valladolid, SpainPsiquiatría, Hospital Clínico Universitario Valldolid, Valladolid, Spain Introduction Lithium is widely used in the treatment of the bipolar disorder. Once introduced, it is necessary to carry out an adequate control of the therapeutic range, since it is potentially toxic, and can affect various organs. Objectives To present the case of a patient suffering from lithium poisoning and to review the symptoms of lithium poisoning. Methods A descriptive study of a clinical case and review of the literature Results 49-year-old woman, married. Diagnosed with bipolar disorder. She went to the emergency room due to a low level of consciousness, kidney failure, trembling of the limbs, hyperthermia and leukocytosis. In the last two weeks, the patient has reduced her intake of food, not water, finding herself more and more shaky and less reactive. Lithium in blood at admission 1.71, so conventional dialysis was performed with a progressive decrease into 0.65. On examination, he is practically mutist, bradypsychia with a significant response latency. Clinical judgment: Accidental lithium poisoning. Conclusions The primary site of toxicity is the central nervous system and clinical manifestations vary from asymptomatic supratherapeutic drug concentrations to clinical toxicity such as confusion, ataxia, or seizures. Severe lithium neurotoxicity occurs almost exclusively in the context of chronic therapeutic administration of lithium and rarely results from acute ingestion of lithium, even in patients currently taking lithium. As such it is an iatrogenic illness, occurring in patients who have identifiable clinical risk factors: nephrogenic diabetes insipidus, older age, abnormal thyroid function and impaired renal function. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933821017284/type/journal_articlelithium toxicitybipolar disorderlithium |
| spellingShingle | E. Rodríguez Vázquez C. Capella Meseguer I. Santos Carrasco J. Gonçalves Cerejeira A. Gonzaga Ramírez M. Queipo De Llano De La Viuda G. Guerra Valera C. De Andrés Lobo T. Jiménez Aparicio C. Vallecillo Adame Lithium toxicity. A case report European Psychiatry lithium toxicity bipolar disorder lithium |
| title | Lithium toxicity. A case report |
| title_full | Lithium toxicity. A case report |
| title_fullStr | Lithium toxicity. A case report |
| title_full_unstemmed | Lithium toxicity. A case report |
| title_short | Lithium toxicity. A case report |
| title_sort | lithium toxicity a case report |
| topic | lithium toxicity bipolar disorder lithium |
| url | https://www.cambridge.org/core/product/identifier/S0924933821017284/type/journal_article |
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