Severe lithium intoxication in a child

A mentally retarded six-year-old child became severely intoxicated with lithium carbonate whilst on maintenance lithio-therapy for control of aggressive behaviour in an institutional setting. His lithium level of 5.15 mmol/l returned to normal after two weeks. Treatment consisted of an initial saline infusion but was otherwise supportive. Although lithium toxicity is rare in children this may be because it had been used infrequently and cautiously. We feel his young age and situation accounted for some of the severity of his intoxication, and wish to stress the potential toxicity of lithium when used under these circumstances.