Graziani Romina, Monti Mattia, Sejdiu Brunilda, Gozzetti Francesco, Martelli Davide, Tampieri Elena, Isola Elisabetta, Zanchelli Fulvia, Briganti Mario, Cenacchi Giovanna, Fabbrizio Benedetta, Buscaroli Andrea
UO Nefrologia e Dialisi, Ospedale Santa Maria delle Croci, Ravenna, Ausl Romagna.
SSD di Diagnostica Istopatologica e Molecolare degli Organi solidi e del relativo Trapianto Policlinico S. Orsola-Malpighi Bologna.
G Ital Nefrol. 2019 Jul 24;36(4):2019-vol4.
Lithium is a largely used and effective therapy in the treatment of bipolar disorder. Its toxic effects on kidneys are mostly diabetes insipidus, hyperchloremic metabolic acidosis and tubulointerstitial nephritis. Also, a correlation between lithium and minimal change disease has sometimes been described. We report here the case of a patient with severe bipolar disorder on lithium therapy who, without any pre-existing nephropathy, developed nephrotic syndrome and AKI with histopathologic findings pointing to minimal change disease. The patient was treated with symptomatic therapy; the discontinuation of lithium therapy resulted in the remission of AKI and of the nephrotic syndrome, thus suggesting a close relationship between lithium and minimal change disease.
锂盐是治疗双相情感障碍广泛使用且有效的疗法。其对肾脏的毒性作用主要是尿崩症、高氯性代谢性酸中毒和肾小管间质性肾炎。此外，有时也描述过锂盐与微小病变病之间的相关性。我们在此报告一例接受锂盐治疗的重度双相情感障碍患者，该患者无既往肾病，却出现了肾病综合征和急性肾损伤，组织病理学检查结果指向微小病变病。该患者接受了对症治疗；停用锂盐治疗后急性肾损伤和肾病综合征缓解，这表明锂盐与微小病变病之间存在密切关系。
