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2022
- ISIDORE Id: 10670/1.df144b...
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Hugo Tiv et al., « Diagnostic challenge: Lithium neurotoxicity with normal lithium level », Néphrologie & Thérapeutique, ID : 10670/1.df144b...
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We describe the case of a 54-year-old woman with bipolar disorder, under follow-up with psychiatry and treated with lithium and a selective serotonin reuptake inhibitor (escitalopram) and lamotrigine, who presented with lithium poisoning with an altered state of consciousness caused by a supposed mismanagement of her treatment. Lithium poisoning was suggested based on neurological clinical features, but blood tests showed a lithium concentration within therapeutic range of 1.2 mmol/L (N: 0.6–1.2 mmol/L). The classic laboratory findings for lithium poisoning (hypercalcemia and diabetes insipidus) confirmed the diagnosis. The patient was transferred to our nephrology department, where she underwent two dialysis sessions resulting in improvement in clinical and laboratory terms, confirming the diagnosis of lithium poisoning despite the normal blood levels. She was subsequently transferred to the psychiatry department for follow-up and treatment adjustment.
