Pamathy Gnanaselvam, Jayarajah Umesh, Wangmo Tshering, Banagala Anura S K
Department of Surgery, National Hospital of Sri Lanka, Colombo, Western Province, Sri Lanka.
Indian J Psychol Med. 2018 Jul-Aug;40(4):378-380. doi: 10.4103/IJPSYM.IJPSYM_305_17.
Lithium induced primary hyperparathyroidism is an uncommon endocrine side effect of long term lithium therapy. We studied the case of a 67-year-old female patient on long term lithium therapy for bipolar affective disorder, who developed resistant hypercalcaemia and parathyroid adenoma which required parathyroidectomy. Furthermore, the effect of chronic lithium therapy on parathyroid glands and serum calcium levels, its pathogenesis, and management were reviewed. Periodic monitoring of serum calcium levels in patients on long term lithium therapy should be practiced. Surgical removal of the affected parathyroid gland is an effective treatment modality in selected patients with resistant hypercalcaemia and parathyroid adenoma and/or hyperplasia. However, regular post-operative follow up is needed for early identification of recurrence in such patients.
锂诱导的原发性甲状旁腺功能亢进是长期锂治疗罕见的内分泌副作用。我们研究了一例67岁女性患者，她因双相情感障碍接受长期锂治疗，出现了难治性高钙血症和甲状旁腺腺瘤，需要进行甲状旁腺切除术。此外，还回顾了慢性锂治疗对甲状旁腺和血清钙水平的影响、其发病机制及治疗方法。对于长期接受锂治疗的患者，应定期监测血清钙水平。对于选定的难治性高钙血症和甲状旁腺腺瘤及/或增生患者，手术切除受影响的甲状旁腺是一种有效的治疗方式。然而，此类患者术后需要定期随访，以便早期发现复发情况。
