Lithium Intoxication and Nephrogenic Diabetes Insipidus in a Bipolar Patient-Case Report

雙極性疾患患者合併鋰鹽中毒和腎性尿崩症－病例報告

蔡芳茹(Fang-Ju Tsai) ； 吳佳璇(Cha-Shun Wu) ； 高淑芬(Susan Shur-Fen Gau)

《慈濟醫學雜誌》 17卷3期 (2005/06) Pp. 181-185

https://doi.org/10.6440/TZUCMJ.200506.0181

摘要

鋰鹽會引起腎性尿崩症增加鋰鹽中毒危險性，我們報告一位52歲女性雙極性疾患患者，使用鋰鹽維持治療達20年之久，住院前三年未出現躁期或鬱期發作，住院前一年開始出現多喝多尿現象，前一個月出現鬱期合併精神病性症狀。入院後發現病人有瞻妄、錐體外徑症狀，病人立即停用鋰鹽，及給於以支持性療法治療。住院第12天後其症狀緩解，住院第22天出院，但其於出院當時仍呈多尿多喝與輕度認知功能障礙。依據文獻回顧及治療此病人之臨床經驗，發現鋰鹽引起的腎性尿崩症以及鋰鹽中毒，宜早期發現治療，以免造成併發症。

關鍵字

鋰鹽中毒 ； 腎性尿崩症 ； 雙極性疾忠

並列摘要

Nephrogenic diabetes insipidus has been reported to increase the risk for lithium intoxication. We report on a 52-year-old woman with bipolar disorder who had been treated with lithium regularly for twenty years. She had developed polyuria and polydipsia one year previously, and a depressive episode with psychotic features one month before this admission. She had not had a manic or a depressive episode for three years. Lithium was discontinued and supportive treatment was provided when lithium intoxication was diagnosed on the first day of hospitalization. Despite the disappearance of symptoms of intoxication on the 12th day of her 22 day hospitalization, she still suffered from polyuria, polydipsia, and mild cognitive impairment when she was discharged. This case report emphasizes the importance of early identification and treatment of nephrogenic diabetes insipidus and lithium intoxication in lithium-treated patients to prevent irreversible sequelae from a combination of these two conditions.

並列關鍵字

bipolar disorder ； nephrogenic diabetes insipidus ； lithium intoxication