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ARDS following acute lithium carbonate intoxication

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Abstract

Lithium is a two-edged sword; it is on the one hand a unique drug with invaluable psychoactive potential and on the other a drug which can cause multisystem toxicity and even death. We present a case of severe lithium intoxication with multiple organ involvement. Our patient developed the adult respiratory distress syndrome (ARDS), nephrogenic diabetes insipidus (DI), distinctive neurological abnormalities, and hyperglycemia. We believe that this is a case of ARDS due to lithium toxicity in which elevated left atrial pressures were excluded by right heart catheterization and suggest a causal relationship between lithium and ARDS.

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References

  1. Hansen HE, Amsiden A (1978) Lithium intoxication. Q J Med 186:123–144

    Google Scholar 

  2. Murray JB (1989) New applications of lithium therapy. J Psychol 134:55–73

    Google Scholar 

  3. Hall RCW, Perl M, Pfefferbaum B (1979) Lithium therapy and toxicity. Am Fam Practice 19:133–139

    Google Scholar 

  4. Rosenthal NE, Goodwin FK (1982) The role of the lithium ion in medicine. Am Rev Med 33:555–568

    Google Scholar 

  5. El-Mallakh RS (1990) Lithium. Connecticut Med 54:115–125

    Google Scholar 

  6. Simard M, Gumbiner B, Lee A et al (1989) Lithium carbonate intoxication: a case report and review of the literature. Arch Intern Med 149:36–46

    Google Scholar 

  7. DeMontigny C, Coumoyer G, Morisette R et al (1983) Lithium carbonate addition in tricyclic antidepressant-resistant unipolar depression. Arch Gen Psychiatry 40:1327–1334

    Google Scholar 

  8. Heninger GR, Charley DS, Sternberg DE (1983) Lithium carbonate augmentation of antidepressant treatment. Arch Gen Psychiatry 40:1335–1342

    Google Scholar 

  9. Campbell M, Perry R, Green WH (1984) Use of lithium in children and adolescents. Psychosomatics 25:95–106

    Google Scholar 

  10. Delong RG, Aldershof AL (1987) Long-term experience with lithium treatment in childhood: correlation with clinical diagnosis. J Am Acad Child Adolesc Psychiatry 26:389–394

    Google Scholar 

  11. Liskow BI, Goodwin DW (1987) Pharmacological treatment of alcohol intoxication, withdrawal and dependence. A critical review. J Stud Alcohol 48:356–370

    Google Scholar 

  12. Delva NJ, Leterdia FJJ (1982) Lithium treatment in schizophrenia and schizo-affective disorders. Br J Psychiatry 141:387–400

    Google Scholar 

  13. Kudrow L (1977) Lithium prophylaxis for chronic cluster headache. Headache 17:15–18

    Google Scholar 

  14. Richman CM, Maki MM, Wiser PA et al (1984) Effect of lithium carbonate on chemotherapy-induced neutropenia and thrombocytopenia. Am J Hematol 16:313–323

    Google Scholar 

  15. Roberts DE, Berman SM, Nakasatao S et al (1988) Effect of lithium carbonate on zidovudine-associated neutropenia in the acquired immunodeficiency syndrome. Am J Med 85:428–431

    Google Scholar 

  16. Winchester JF (1990) Lithium. In: Haddad LM (ed) Clinical management of poisoning and drug overdose. Saunders, Philadelphia, pp 656–665

    Google Scholar 

  17. Lawler PG, Cove-Smith JR (1986) Acute respiratory failure following lithium intoxication. Anaesthesia 41:623–627

    Google Scholar 

  18. Petty TL, Ashbough DG (1971) The adult respiratory distress syndrome: clinical factors influencing prognosis and principles of management. Chest 60:233–243

    Google Scholar 

  19. Murray JF, Matthay MA, Luce JM, Flick MR (1988) An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis 138:720–725

    Google Scholar 

  20. Colice GL, Matthay MA, Bass E, Matthay RA (1984) Neurogenic pulmonary edema. Am Rev Respir Dis 130:941–948

    Google Scholar 

  21. Light RW (1988) Pneumothorax. In: Murray JF, Nadel JA (eds) Textbook of respiratory medicine. Saunders, Philadelphia, pp 1745–1759

    Google Scholar 

  22. Campkin TV (1982) Air embolism: placement of central venous catheters. Anesthesiology 56:406–409

    Google Scholar 

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Friedman, B.C., Bekes, C.E., Scott, W.E. et al. ARDS following acute lithium carbonate intoxication. Intensive Care Med 18, 123–124 (1992). https://doi.org/10.1007/BF01705046

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  • DOI: https://doi.org/10.1007/BF01705046

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