Multisystemic Toxicity by Lithium: A Case Report

Authors

  • Juliana Nunes Departamento de Psiquiatria e Saúde mental da ULS da Guarda
  • Diana Brigadeiro Departamento de Psiquiatria e Saúde mental da ULS da Guarda
  • Nádia Potlog Interna de Medicina Interna do Serviço de Medicina Interna da ULS da Guarda
  • Paula Neves Médica de Medicina Interna do Serviço de Medicina Interna da ULS da Guarda
  • Joana Vedes Médica de Medicina Interna do Serviço de Medicina Interna da ULS da Guarda
  • António Pissarra da Costa Departamento de Psiquiatria e Saúde mental da ULS da Guarda

DOI:

https://doi.org/10.25752/psi.14295

Keywords:

lithium, Adverse Effects, Bipolar Affective Disorder, Lithium Toxicity

Abstract

Background: Lithium carbonate is used as a first line treatment of bipolar disorder, however given its narrow therapeutic range, it needs regular monitoring of lithium serum levels and occurrence of any symptoms and signs of toxicity.

Aims: To illustrate diagnosis complexity and approach to prolonged lithium treatment associated toxicity.

Methods: Report of a clinical case and review of the literature.

Results: The authors present the case of a 53-year-old woman diagnosed with bipolar disorder that had been medicated with lithium carbonate at a dose of 600 mg / day for 28 years. Nevertheless, this person abandoned clinical follow-up 8 years before, maintaining unmonitored medication. The patient was admitted to the emergency department due to disorientation, incoherent speech, ataxia and tremors. From complementary exams, it can be highlighted the existence of lithium serum levels of 4.07 mmol/L, constituting a medical emergency.

Conclusion: Treatment with lithium, without clinical and laboratory monitoring, may lead to severe multisystemic toxicity, and eventually be fatal.

Author Biographies

Juliana Nunes, Departamento de Psiquiatria e Saúde mental da ULS da Guarda

Interna de Formação específica em Psiquiatria no Departamento de Saúde mental da ULS da Gurda

Assistente convidada do Departamento de Psiquiatria da Universidade da Beira Interior - Covilhã

 

Diana Brigadeiro, Departamento de Psiquiatria e Saúde mental da ULS da Guarda

Interna de Formação específica em Psiquiatria no Departamento de Saúde mental da ULS da Gurda

Assistente convidada do Departamento de Psiquiatria da Universidade da Beira Interior - Covilhã

 

Nádia Potlog, Interna de Medicina Interna do Serviço de Medicina Interna da ULS da Guarda

Serviço de Medicina Interna da ULS da Guarda

Paula Neves, Médica de Medicina Interna do Serviço de Medicina Interna da ULS da Guarda

Médica de Medicina Interna do Serviço de Medicina Interna da ULS da Guarda

Joana Vedes, Médica de Medicina Interna do Serviço de Medicina Interna da ULS da Guarda

Médica de Medicina Interna do Serviço de Medicina Interna da ULS da Guarda

António Pissarra da Costa, Departamento de Psiquiatria e Saúde mental da ULS da Guarda

Chefe de Serviço do Departamento de Saúde mental da ULS da Gurda

Assistente convidado do Departamento de Psiquiatria da Universidade da Beira Interior - Covilhã

 

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Published

2020-07-24

Issue

Vol. 16 No. 1 (2018)

Section

Case Reports

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