Nordenström J, Strigård K, Perbeck L, Willems J, Bågedahl-Strindlund M, Linder J
Department of Surgery, Huddinge University Hospital, Sweden.
Eur J Surg. 1992 Apr;158(4):207-11.
To clarify the association between treatment of affective psychiatric disorders with lithium, and the development of secondary hyperparathyroidism.
Retrospective review of medical records, 1973-89.
17 patients with affective psychiatric disorders who were treated with lithium (n = 6) or with tricyclic antidepressant, or neuroleptic, drugs (n = 11) all of whom were operated on for hyperparathyroidism.
Duration of lithium therapy and parathyroid histology.
Parathyroid hyperplasia was present in 5 patients who had taken lithium during a median period of 13 years. A parathyroid adenoma was found in one patient treated with lithium for three years. Ten of the 11 patients who had been treated with tricyclic antidepressant, or neuroleptic drugs had a parathyroid adenoma and the remaining one had an adenoma as an underlying cause of hyperparathyroidism.
Hyperparathyroidism in patients who have undergone long term treatment with lithium is associated with parathyroid hyperplasia. This indicates that lithium may exert a chronic stimulus that results in secondary hyperparathyroidism.
