Cesaro Antonio, Faggian Guido, Del Piano Carlo, Del Piano Domenico, Vitagliano Arcangelo, Faggian Roberto, Silvestro Eufrasia, Faggian Angela
UOSD Nefrologia ed Emodialisi, P.O. Moscati, Aversa (CE), Italia.
UOC Anestesia e Rianimazione, P.O. Moscati, Aversa (CE), Italia.
G Ital Nefrol. 2021 Apr 14;38(2):2021-vol2.
Lithium is the milestone of psychiatric patients' therapy, in particular in bipolar disorder. Despite its high therapeutic efficacy, there are several side effects (renal, thyroid, parathyroid, dermatological) and management problems linked to its narrow therapeutic range, which exposes patients to a high risk of toxicity. We describe the case of a male patient with bipolar disorder in therapy with lithium sulfate who developed a severe acute-on-chronic intoxication. He came to our attention in a somnolent state with lithemia >3 mEq/L and therefore underwent hemodialysis. In view of the high toxicity of lithium, a timely and correct therapeutic choice is important to improve the patient's outcome. In this context, considering lithemia, but also kidney function and the patient's clinical status, it is necessary to consider extracorporeal treatments, of which hemodialysis is the most preferable.
锂是精神疾病患者治疗的里程碑,尤其是在双相情感障碍的治疗中。尽管其治疗效果显著,但仍存在一些副作用(肾脏、甲状腺、甲状旁腺、皮肤方面的)以及与治疗窗狭窄相关的管理问题,这使患者面临高中毒风险。我们描述了一名接受硫酸锂治疗的双相情感障碍男性患者发生严重急性慢性中毒的病例。他因锂血症>3 mEq/L处于嗜睡状态前来就诊,因此接受了血液透析。鉴于锂的高毒性,及时且正确的治疗选择对于改善患者预后很重要。在此背景下,考虑锂血症,同时兼顾肾功能和患者的临床状况,有必要考虑体外治疗,其中血液透析是最可取的。