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Observational Study
. 2017 Feb;29(1):46-48.

[Acute lithium poisoning: epidemiology, clinical characteristics, and treatment]

[Article in Spanish]
Víctor Burguera Vion  1 , José Manuel Montes  2 , José Manuel Del Rey  3 , Maite Rivera-Gorrín  1 , José María Rodao  2 , Maite Tenorio  1 , Jerónimo Saiz-Ruiz  2 , Fernando Liaño  1
Affiliations
  • PMID: 28825269
Free article
Observational Study

[Acute lithium poisoning: epidemiology, clinical characteristics, and treatment]

[Article in Spanish]
Víctor Burguera Vion et al. Emergencias. 2017 Feb.
Free article

Abstract
in English, Spanish

Lithium continues to be the treatment of choice for bipolar disorder. Acute lithium poisoning is a potentially serious event. We present a retrospective observational significative study of episodes of acute lithium poisoning during a 52- month period. Poisoning was defined by a blood lithium concentration of 1.5 mEq/L or higher. We analyzed treatment and epidemiologic and clinical characteristics of 70 episodes were identified (incidence density among treated patients, 1.76 per 100 patient-years). The most frequent cause of lithium poisoning was a concurrent medical condition (46%). Most poisonings were mild (74.2%), but neurologic involvement was identified in 40.3%. Electrocardiographic abnormalities were found in 8 cases. Acute renal failure, found in 23 patients (37.1%), was mild in most cases, although 11 patients required hemodialysis. We concluded that acute lithium poisoning is an uncommon complication, but risk needs to be lowered. Patients should be warned to avoid dosage errors and to take special care during concurrent illnesses and while taking other medications.

El litio sigue siendo el tratamiento de elección en el trastorno bipolar. La intoxicación aguda por litio (IAL) es un cuadro potencialmente grave. Se presenta un estudio observacional, retrospectivo de las IAL observadas durante un periodo de 52 meses. Se definió como IAL cuando se registró una concentración de litio en sangre 1,5 mEq/L. Se analizaron sus características clínicas, epidemiológicas y su tratamiento de 70 episodios de IAL (densidad de incidencia: 1,76 IAL por cada 100 pacientes tratados-año). La causa más frecuente de IAL fue un proceso patológico intercurrente (46%). La mayoría fueron de carácter leve (74,2 %), con sintomatología neurológica en el 40,3%. En 8 IAL hubo alteraciones electrocardiográficas, 23 IAL (37,1%) se asociaron con fracaso renal agudo, la mayoría de carácter leve y 11 precisaron hemodiálisis. Se concluye que la IAL es una complicación infrecuente, pero es necesario disminuir su riesgo advirtiendo al paciente ante la existencia de procesos intercurrentes, errores en la posología o polimedicación.

Keywords: Acute poisoning; Bipolar disorder; Fracaso renal; Intoxicación; Lithium; Litio; Renal failure; Trastorno bipolar.

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