Lieber Ingrid, Ott Michael, Lundqvist Robert, Eliasson Mats, Sandlund Mikael, Werneke Ursula
Sunderby Research Unit, Department of Clinical Sciences, Psychiatry, Umeå University, 90185 Umeå, Sweden.
Department of Public Health and Clinical Medicine, Umeå University, 90185 Umeå, Sweden.
J Clin Med. 2022 May 27;11(11):3041. doi: 10.3390/jcm11113041.
(1) Background: It has been suggested that hyperthyroxinaemia is a risk factor for lithium intoxication by altering tubular renal function. (2) Methods: We determined the relevance of hyperthyroxinaemia as a risk factor for lithium intoxication in patients with bipolar or schizoaffective disorder in the framework of the LiSIE (Lithium-Study into Effects and Side Effects) retrospective cohort study. Of 1562 patients included in the study, 897 patients had been exposed to lithium at any time between 1997 and 2017 with 6684 person-years of observation. (3) Results: There were 65 episodes of unintentional lithium intoxication in 53 patients. There were nine episodes with hyperthyroxinaemia at the time of lithium intoxication, yielding an incidence of 1.3 episodes/1000 person-years. For all nine episodes, we could identify alternative, more plausible, explanations for the observed lithium intoxications. (4) Conclusions: We conclude that hyperthyroxinaemia-associated unintentional lithium intoxication is an uncommon event. A direct causal link between hyperthyroxinaemia and altered tubular renal function remains elusive. Increasing the frequency of routine thyroid function tests seems unlikely to decrease the risk of lithium intoxication.
(1) 背景：有人提出，甲状腺素血症通过改变肾小管功能而成为锂中毒的一个危险因素。(2) 方法：在LiSIE（锂的效应和副作用研究）回顾性队列研究的框架内，我们确定了甲状腺素血症作为双相情感障碍或精神分裂症患者锂中毒危险因素的相关性。在纳入研究的1562名患者中，897名患者在1997年至2017年期间的任何时间接触过锂，观察时间为6684人年。(3) 结果：53名患者发生了65次非故意锂中毒事件。锂中毒时有9次甲状腺素血症发作，发病率为1.3次/1000人年。对于所有9次发作，我们能够为观察到的锂中毒找到其他更合理的解释。(4) 结论：我们得出结论，与甲状腺素血症相关的非故意锂中毒是一种罕见事件。甲状腺素血症与肾小管功能改变之间的直接因果关系仍然难以捉摸。增加常规甲状腺功能检查的频率似乎不太可能降低锂中毒的风险。
