J Korean Neuropsychiatr Assoc.  2014 Nov;53(6):434-437. 10.4306/jknpa.2014.53.6.434.

A Case of Lithium Toxicity within Normal Creatinine Range during Lithium Maintenance Treatment

• Ohm HS
• Kim H
• Han SH
• Kim B

• KMID: 2383334
• DOI: http://doi.org/10.4306/jknpa.2014.53.6.434

Abstract

Lithium is a widely used drug for treatment of bipolar disorder. Because of its narrow therapeutic range and renal toxicity, most clinical guidelines recommend regular monitoring of serum lithium level and kidney function for patients taking lithium. We report on a case of a 20 year-old man with occurrence of lithium toxicity after more than one year of lithium maintenance therapy with daily lithium intake of 900 mg. His serum creatinine level was within normal range at admission and elevated compared to his baseline, but still within normal range when lithium toxicity occurred. Acute kidney injury associated with dehydration, analgesics, and nephrotoxic effect of lithium might be a risk factor of lithium toxicity. This case showed the importance of thorough monitoring of serum creatinine level change even if its elevated result is within normal range in observing renal function of patients treated with lithium.

Keyword

Lithium toxicity; Creatinine; Bipolar affective disorder; Non-steroidal anti-inflammatory agents

MeSH Terms

Acute Kidney Injury
Analgesics
Anti-Inflammatory Agents, Non-Steroidal
Bipolar Disorder
Creatinine*
Dehydration
Humans
Kidney
Lithium*
Reference Values
Risk Factors
Analgesics
Anti-Inflammatory Agents, Non-Steroidal
Creatinine
Lithium

Figure

• 

  Fig. 1 Serum lithium, BUN, creatinine concentration. BUN : Blood urea nitrogen.

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