Mecê Alexandre Motta, Abreu Vitor Corsaletti, Lamas Gustavo Manginelli, Tacla Rafaella do Rosário, Minekawa Thais Benício, Ramos Celso Dario, Balthazar Marcio Luiz Figueiredo
Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Neurologia, São Paulo SP, Brazil.
Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Radiologia, Divisão de Medicina Nuclear, São Paulo SP, Brazil.
Dement Neuropsychol. 2022 Apr-Jun;16(2):249-252. doi: 10.1590/1980-5764-DN-2021-0105. Epub 2022 Apr 29.
Rapidly progressive dementia (RPD) is a rare neurological disorder. Drug toxicity is among the differential diagnoses, including the use of lithium, in which an overdosage might cause cognitive dysfunction. Clinical suspicion, laboratory confirmation, and drug interruption are key points in the management of lithium intoxication. We described a 66-year-old female patient under treatment with lithium who developed an RPD associated with parkinsonian symptoms. F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) showed an "Alzheimer-like" pattern, while cerebrospinal fluid biomarkers for the disease were negative. There was a significant clinical and radiological improvement after lithium interruption. Lithium intoxication is a potentially reversible cause of RPD, as demonstrated in this case report. Drug discontinuation should be considered even in patients with normal levels of this metal, if cognitive impairment is detected. F-FDG PET/CT images may show an "Alzheimer-like" image pattern in acute intoxication and are useful for monitoring these patients.
快速进展性痴呆（RPD）是一种罕见的神经系统疾病。药物毒性是鉴别诊断的内容之一，包括锂的使用，过量使用锂可能导致认知功能障碍。临床怀疑、实验室确诊以及停用药物是锂中毒管理的关键点。我们描述了一名66岁正在接受锂治疗的女性患者，她出现了与帕金森症状相关的快速进展性痴呆。氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）显示出“阿尔茨海默样”模式，而该疾病的脑脊液生物标志物为阴性。停用锂后，临床和影像学有显著改善。如本病例报告所示，锂中毒是快速进展性痴呆的一个潜在可逆病因。如果检测到认知障碍，即使该金属水平正常的患者也应考虑停药。F-FDG PET/CT图像在急性中毒时可能显示出“阿尔茨海默样”图像模式，对监测这些患者很有用。
