Acute pulmonary oedema due to lithium intoxication

Area of Science:

• Nephrology
• Toxicology
• Cardiology

Background:

• Lithium is a common mood stabilizer, but overdose can lead to severe toxicity.
• Acute lithium intoxication presents a diagnostic and therapeutic challenge, particularly when affecting multiple organ systems.

Observation:

• A patient presented with respiratory failure due to pulmonary edema and profound stupor, indicative of severe lithium toxicity.
• Initial lithium concentrations were markedly elevated at 3.15 mmol/l in plasma and 27.6 mmol/l in urine.

Findings:

• The primary clinical manifestation was respiratory compromise, potentially linked to lithium-induced myocardial depression.
• Symptomatic treatment, including oxygen, digitalis, and diuretics, led to gradual recovery of both pulmonary and neurological functions.

Implications:

• This case highlights the critical importance of monitoring lithium levels in patients with suspected overdose.
• Prompt and appropriate symptomatic management can effectively reverse severe lithium toxicity and its associated complications.