A true dialytic urgency: lithium intoxication
Lithium carbonate is a drug widely used in Colombia for the treatment of various psychiatric pathologies such as treatment in patients with bipolar affective disorder, however its narrow therapeutic index predisposes to the occurrence of acute poisoning, unlikely to happen but could be fatal.
It should be said that its diagnosis requires a high rate of suspicion because it presents various clinical manifestations such as neuropsychiatric symptoms and even mental disorders of an organic type that can be complicated by an acute kidney injury requiring emergency dialysis therapy.
We report the case of a patient who presented to the emergency department with alteration in the state of consciousness in whom lithium poisoning was found and who required hemodialysis in an early stage.
In conclusion, in a patient with risk factor and therapy with this drug is very important to guide appropriate treatment, and also discard differential diagnosis, in order to avoid fatal consequences.
Sturzbecher-Höhne M, Kissner R, Nauser T, Koppenol WH. Preparation and properties of lithium and sodium peroxynitrite. Chem Res Toxicol. 2008 Dec;21(12):2257–9.
Connor H. Drug Discovery—A History. J R Soc Med. 2005 Nov;98(11):517–8.
Jefferson JW, Kalin NH. Serum Lithium Levels and Long-term Diuretic Use. JAMA. 1979 Mar 16;241(11):1134–6.
Gelenberg AJ, Hopkins HS. Report on efficacy of treatments for bipolar disorder. Psychopharmacol Bull. 1993;29(4):447–56.
Amdisen A. Clinical features and management of lithium poisoning. Med Toxicol Adverse Drug Exp. 1988 Dec;3(1):18–32.
Gitlin M. Lithium side effects and toxicity: prevalence and management strategies. Int J Bipolar Disord. 2016 Dec;4(1):27.
Offerman SR, Alsop JA, Lee J, Holmes JF. Hospitalized lithium overdose cases reported to theCalifornia Poison Control System. Clin Toxicol. 2010 Jun 1;48(5):443–8.
Dupuis RE, Cooper AA, Rosamond LJ, Campbell-Bright S. Multiple Delayed Peak Lithium Concentrations following Acute Intoxication with an Extended-Release Product. Ann Pharmacother. 1996 Apr 1;30(4):356–60.
Timmer RT, Sands JM. Lithium Intoxication. J Am Soc Nephrol. 1999 Jan 3;10(3):666–74.
Coker C, Poore CA, Li X, Mobley HL. Pathogenesis of Proteus mirabilis urinary tract infection. Microbes Infect. 2000 Oct;2(12):1497–505.
Administration of Activated Charcoal or Sodium Polystyrene Sulfonate (KayexalateTM) as Gastric Decontamination for Lithium Intoxication: An Animal Model - Linakis - 1989 - Pharmacology & Toxicology - Wiley Online Library [Internet]. [cited 2018 May 7].
Roberge RJ, Martin TG, Schneider SM. Use of sodium polystyrene sulfonate in a lithium overdose. Ann Emerg Med. 1993 Dec 1;22(12):1911–5.
Fenves AZ, Emmett M, White MG. Lithium intoxication associated with acute renal failure. South Med J. 1984 Nov;77(11):1472–4.
Decker BS, Goldfarb DS, Dargan PI, Friesen M, Gosselin S, Hoffman RS, et al. Extracorporeal Treatment for Lithium Poisoning: Systematic Review and Recommendations from the EXTRIP Workgroup. Clin J Am Soc Nephrol CJASN. 2015 May 7;10(5):875–87.
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