Niessen R, Sottiaux T, Schillaci A, Lejeune F
Service des Soins Intensifs, Clinique Notre-Dame de Grâce, Gosselies, Belgique.
Service de Chirurgie Digestive, Clinique Notre-Dame de Grâce, Gosselies, Belgique.
Rev Med Liege. 2018 Feb;73(2):82-87.
Since many years a correlation between neuropsychiatric disorders and eating disorders resulting in obesity is well established. According to different studies, 1.2 - 4 % of patients scheduled for bariatric surgery are taking lithium as a mood stabilizer treatment for bipolar disorder. We are presenting a case of lithium toxicity after vertical sleeve gastrectomy surgery in a 40 years-old female. The patient developed severe neurological and renal signs needing an intensive care unit admission and continuous veno-venous hemodiafiltration. A literature review provides insights into physiological and pharmacokinetics changes that could contribute to lithium poisoning after bariatric surgery. This article illustrates the need for closer monitoring of lithium serum levels following bariatric surgery and presents guidance in managing lithium therapy during perioperative period based on experts' opinion.
多年来，神经精神疾病与导致肥胖的饮食失调之间的关联已得到充分证实。根据不同研究，计划接受减肥手术的患者中有1.2% - 4%正在服用锂盐作为双相情感障碍的情绪稳定剂治疗。我们报告一例40岁女性在垂直袖状胃切除术后发生锂中毒的病例。该患者出现严重的神经和肾脏症状，需要入住重症监护病房并进行持续静脉 - 静脉血液透析滤过。文献综述揭示了减肥手术后可能导致锂中毒的生理和药代动力学变化。本文阐述了减肥手术后密切监测锂血清水平的必要性，并根据专家意见提供围手术期锂治疗管理的指导。
