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Lithium intoxication with acute renal failure and death.
S R Rose1, W Klein-Schwartz, G M Oderda
1Clinical Toxicology Services, University Hospital, Jacksonville, FL 32209.
Drug Intelligence & Clinical Pharmacy
|September 1, 1988
Summary
Acute lithium carbonate ingestion in a 65-year-old female led to severe gastrointestinal symptoms, acute renal failure, and cardiovascular collapse. Despite dialysis, the patient died, suggesting a direct nephrotoxic effect of lithium.
Area of Science:
- Nephrology
- Clinical Toxicology
- Pharmacology
Background:
- Lithium carbonate is widely prescribed for bipolar disorder.
- Acute lithium toxicity can occur following overdose.
- The toxic effects of lithium on renal function require further elucidation.
Observation:
- A 65-year-old female presented with gastrointestinal symptoms 8-10 hours after acute lithium carbonate ingestion.
- Serum lithium concentration was significantly elevated at 8.5 mEq/L.
- The patient developed acute renal failure, altered mental status, and cardiovascular collapse within 48 hours.
Findings:
- Despite intensive treatment including hemodialysis and peritoneal dialysis, the patient's condition deteriorated.
- The patient expired approximately 4.5 days after lithium ingestion.
- The clinical course suggests a severe, direct nephrotoxic effect of lithium.
Implications:
- This case highlights the potential for severe renal and cardiovascular toxicity following acute lithium overdose.
- Prompt recognition and management of lithium toxicity are crucial.
- Further research into the mechanisms of lithium-induced nephrotoxicity is warranted.