改善药物依从性后发生锂诱导的肾性尿崩症：一例报告
Lithium-induced nephrogenic diabetes insipidus following improved medication compliance: a case report.
作者信息
Annor Eugene, Bhattacharya Ishita, Bass Mary, Horvath Emily M
机构信息
Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL, 61637, USA.
University of Illinois College of Medicine, Peoria, IL, USA.
出版信息
J Med Case Rep. 2025 Jan 23;19(1):31. doi: 10.1186/s13256-025-05034-3.
BACKGROUND
Nephrogenic diabetes insipidus is a rare, often underrecognized complication of long-term lithium therapy. Lithium-induced nephrogenic diabetes insipidus results from chronic renal exposure, leading to significant polyuria, dehydration, and hypernatremia.
CASE PRESENTATION
We describe a case of a 55-year-old White caucasian male with a schizoaffective disorder managed with lithium who presented with altered mental status and electrolyte abnormalities following a recent stroke. Evaluation revealed nephrogenic diabetes insipidus as the primary etiology, likely exacerbated by recent changes in medication adherence. The patient responded well to fluid resuscitation, reduced lithium dosage, and targeted electrolyte management.
CONCLUSION
This case underscores the need for vigilance in monitoring patients with nephrogenic diabetes insipidus on chronic lithium therapy, as early recognition and treatment are essential in preventing renal impairment and improving clinical outcomes.
背景
肾性尿崩症是长期锂盐治疗罕见且常未被认识的并发症。锂诱导的肾性尿崩症源于肾脏长期暴露，导致显著的多尿、脱水和高钠血症。
病例介绍
我们描述了一名55岁患有精神分裂症的白人男性，其因锂盐治疗精神分裂情感障碍，近期中风后出现精神状态改变和电解质异常。评估显示肾性尿崩症是主要病因，可能因近期服药依从性改变而加重。患者对液体复苏、减少锂盐剂量及针对性的电解质管理反应良好。
结论
该病例强调了对接受慢性锂盐治疗的肾性尿崩症患者进行监测时需保持警惕，因为早期识别和治疗对于预防肾功能损害及改善临床结局至关重要。
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