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Published on: September 12, 2018
[Nephrogenic diabetes insipidus during lithium acute intoxication]
J Abodo1, V Seux, P Koffi-Dago
1Service de médecine interne et gériatrie, hôpital de Sainte-Marguerite, 270, boulevard de Sainte-Marguerite, 13274 Marseille cedex 09, France. abodo@ci.refer.org
Annales D'Endocrinologie
|November 23, 2007
Summary
Chronic lithium use can cause acute intoxication, especially with kidney failure. Monitoring serum lithium levels is crucial, particularly during dehydration, to prevent severe neurological and metabolic complications.
Area of Science:
- Nephrology
- Neuroscience
- Endocrinology
Background:
- Lithium is a common mood stabilizer for bipolar disorder.
- Chronic lithium therapy can lead to acute intoxication, particularly when kidney function is compromised.
Observation:
- A 69-year-old woman with a 10-year history of lithium treatment for unipolar manic-depressive psychosis presented with symptoms of acute lithium intoxication.
- The patient experienced neurological deficits (coma), gastrointestinal distress (diarrhea), cardiovascular issues (hypotension), and metabolic disturbances (hypercalcemia).
- Nephrogenic diabetes insipidus was also noted.
Findings:
- Acute lithium intoxication can manifest with a spectrum of severe symptoms, including neurological, gastrointestinal, cardiovascular, and metabolic derangements.
- Kidney failure is a critical factor precipitating lithium toxicity in patients on long-term treatment.
- Dehydration significantly increases the risk of lithium accumulation and subsequent intoxication.
Implications:
- Close monitoring of serum lithium levels is essential for patients undergoing long-term lithium therapy.
- Healthcare providers should be vigilant for signs of lithium toxicity, especially in patients with impaired renal function or dehydration.
- Prompt recognition and management of lithium intoxication are vital to prevent potentially irreversible complications.
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