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Related Experiment Videos

[Important hypercalcaemia due to hyperparathyroidism induced by lithium].

C Lions1, P Precloux, E Burckard

  • 1Département d'anesthésie-réanimation, HIA Desgenettes, 108, boulevard Pinel, 69003, Lyon, France. cylions@wanadoo.fr

Annales Francaises D'Anesthesie Et De Reanimation
|March 29, 2005
PubMed
Summary

Long-term lithium treatment for bipolar disorder can cause hyperparathyroidism and hypercalcemia. Surgical removal of parathyroid adenomas is often necessary, as lithium-induced changes may not reverse after discontinuing the medication.

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Area of Science:

  • Endocrinology
  • Psychiatry

Background:

  • Lithium is a cornerstone treatment for bipolar disorder.
  • Lithium use is associated with various side effects, including potential endocrine disturbances.

Observation:

  • A 50-year-old patient on long-term lithium therapy for bipolar illness developed significant hypercalcemia.
  • Despite symptomatic treatment and dialysis, the patient was diagnosed with hyperparathyroidism.

Findings:

  • Neck exploration revealed parathyroid adenomas, confirmed by scintigraphy and subsequently removed.
  • Long-term lithium treatment is linked to hyperparathyroidism, with numerous case reports and some studies suggesting a causal relationship.
  • Metabolic findings include low urinary calcium excretion and normal urinary cyclic AMP excretion.

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Implications:

  • Lithium may directly stimulate parathyroid hormone secretion by interacting with calcium receptors.
  • Discontinuation of lithium does not guarantee normalization of calcium levels.
  • Parathyroidectomy is frequently indicated for lithium-induced hyperparathyroidism.