Dieserud F, Brun A C, Låhne P E, Normann E
Psykiatrisk spesialtjeneste Fylkesavdeling Tønsberg Postboks 2084 3103 Tønsberg.
Tidsskr Nor Laegeforen. 2001 Sep 20;121(22):2602-3.
Lithium treatment, which is extensively used in bipolar affective disorders, may give rise to hypercalcaemia and sometimes to irreversible hyperparathyroidism.
We present a patient who developed hyperparathyroidism following long-term treatment with lithium.
After 15 years on lithium the patient was diagnosed with hypercalcaemia; at the same time the patient stopped her lithium medication. Two years later she developed depression with psychotic symptoms and was given electroconvulsive treatment. Measurements of serum calcium and parathormon showed that she had developed hyperparathyroidism. Neck exploration was performed, and two parathyroid adenomas (weight 650 mg and 880 mg), which had been detected by scintigraphy, were removed. Lithium treatment was restarted. One year later she was normocalcaemic and her mood was normal.
In lithium-induced hyperparamyroidism, lithium should be replaced with other mood stabilizers, preferably an antiepilepticum. If cessation of lithium therapy does not lead to normocalcaemia, parathyroidectomy is indicated.
锂盐治疗广泛应用于双相情感障碍，但可能导致高钙血症，有时还会引发不可逆的甲状旁腺功能亢进。
我们报告一名长期接受锂盐治疗后发生甲状旁腺功能亢进的患者。
服用锂盐15年后，患者被诊断为高钙血症，同时停用锂盐药物。两年后，她出现伴有精神病性症状的抑郁症，并接受了电休克治疗。血清钙和甲状旁腺激素检测显示她已发展为甲状旁腺功能亢进。进行了颈部探查，切除了通过闪烁扫描检测到的两个甲状旁腺腺瘤（重量分别为650毫克和880毫克）。重新开始锂盐治疗。一年后，她血钙正常，情绪也正常。
在锂诱导的甲状旁腺功能亢进中，应将锂盐替换为其他情绪稳定剂，最好是抗癫痫药物。如果停用锂盐治疗后血钙仍未恢复正常，则需进行甲状旁腺切除术。
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