Lithium in haematology: a case of acute intoxication

A 74-year-old woman was treated by lithium carbonate 3 x 300 mg per day for drug-induced aplastic anemia. After 8 days, she suddenly developed severe impairment of consciousness with myoclonias and hypertonia which persisted during 10 days despite lithium withdrawal and sodium chloride infusion. Slight disorders of water and electrolyte metabolism, mild renal failure and the patient's age could have contributed to the development of intoxication. Short-term lithium administration may be life-threatening and should thus be prescribed cautiously in hematological disorders as in other conditions.