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Lithium nephropathy: unique sonographic findings.

Donald N Di Salvo1, Joseph Park, Faye C Laing

  • 1Division of Ultrasound Services, Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA. ddisalvo@partners.org

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
|March 24, 2012
PubMed
Summary

Chronic lithium therapy can cause unique kidney changes. Sonography reveals microcysts and echogenic foci, suggesting lithium nephropathy in patients with kidney issues.

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Area of Science:

  • Nephrology
  • Radiology
  • Pharmacology

Background:

  • Lithium is a common mood stabilizer for bipolar disorder.
  • Long-term lithium use is associated with various renal complications.
  • Early detection of lithium-induced kidney damage is crucial for management.

Purpose of the Study:

  • To describe the characteristic sonographic findings in patients with chronic lithium therapy.
  • To correlate sonographic findings with clinical presentation and other imaging modalities.
  • To propose sonography as a diagnostic tool for lithium nephropathy.

Main Methods:

  • Retrospective case series of 10 adult patients on chronic lithium therapy.
  • Renal sonography was performed on all patients.
  • Computed tomography (CT) and magnetic resonance imaging (MRI) were used in select cases.
  • Renal biopsy was performed in one patient for histological confirmation.

Main Results:

  • Sonography revealed numerous microcysts and punctate echogenic foci in all 10 patients.
  • Chronic renal insufficiency was present in 6 patients; nephrogenic diabetes insipidus in 2.
  • CT confirmed microcysts and microcalcifications; MRI confirmed microcysts.
  • Renal biopsy showed chronic interstitial nephritis, microcysts, and tubular dilatation.

Conclusions:

  • A unique sonographic pattern of microcysts and punctate echogenic foci is associated with chronic lithium therapy.
  • These sonographic findings, when present, should raise suspicion for lithium nephropathy.
  • Sonography may aid in the early diagnosis and monitoring of lithium-induced kidney disease.