Summary
In a retrospective study, 58 outpatients under long-term therapy with lithium were examined with regard to humoral autoantibodies. Fifty-five schizophrenic outpatients under neuroleptic treatment served as controls. We examined antithyroidal antibodies (TAK, MAK), smooth muscle antibodies (SMA), antimitochondrial antibodies (AMA), and antinuclear antibodies (ANA). In the lithium group there was a significant higher prevalence of antithyroidal antibodies (33%) as compared to the control group (9%). Ten patients out of 19 patients with antithyroidal antibodies showed MAK as well as TAK; moreover we found a characteristic pattern: MAK≧TAK. All lithiumtreated patients were euthyroid. Five patients out of the group with antithyroidal antibodies had goiter, three showed temporarily elevated serum concentrations of basal thyroid-stimulating hormone (TSH). We did not find such elevated levels of TSH in the group of eight patients with goiter but without antithyroidal antibodies. There was neither a correlation between the examined parameters and the lithium serum concentration nor the additional psychotropic medication. Our results indicate a significant higher prevalence of antithyroidal antibodies under long-term therapy with lithium as compared to a psychiatric control group. We do not consider these autoimmune phenomena as relevant pathogenetic factors.
Similar content being viewed by others
Literatur
Albrecht J (1980) Effekte von Lithium auf die Schilddrüse. Inn Med 7:69–75
Albrecht J, Kampf D, Müller-Oerlinghausen B (1980) Renal function and biopsy in patients on lithium-therapy. Pharmakopsychiat 13:228–234
Borkowsky W, Shenkman L, Wadler S, Holzman RS, Shopsin B (1980) Adjuvant-like effects of Lithium on peripheral blood mononuclear cells. Adv Exp Med Biol 127:417–427
Brownlie BEW, Chambers ST, Sadler WA, Donald RA (1976) Lithium associated thyroid disease — A report of 14 cases of hypothyroidism and 4 cases of thyrotoxicosis. Aust NZ J Med 6:223–229
Crowe MJ, Lloyd GG, Bloch S, Rosser RM (1973) Hypothyroidism in patients treated with lithium: A review and two case reports. Psychol Med 3:337–342
Davis JM (1976) Overview: Maintenance therapy in psychiatry: II. Affective disorders. Am J Psychiatry 133:1–13
Deniker P, Eyquem A, Bernheim R, Loo H, Delarue P (1978) Thyroid autoantibody levels during lithium therapy. Neuropsychobiology 4:270–275
Doinach D, Roitt JM (1975) Thyroid auto-allergic disease. In: Coombs RRA, Gill PH, Lachmann P (eds): Clinical aspects of immunology, Ch 47. Blackwell Scientific Publications, Oxford
Dosch H-M, Matheson D, Schuurman RKB, Gelfand EW (1980) Anti-suppressor cell effects of lithium in vitro and in vivo. Adv Exp Med Biol 127:447–462
Dry J, Aron-Rosa D, Pradalier A (1974) A propos de l'apparition d'une exophtalmie au cours d'un traitement par le carbonate de lithium. Hyperthyroidie biologique. Thérapie 29:701–708
Edhag O, Swahn Å, Wester PO (1983) Hypothyroidism following lithium treatment? Acta Med Scand 193:553–555
Emerson CH, Dyson WL, Utiger RD (1973) Serum thyrotropin and thyroxine concentrations in patients receiving lithium carbonate. J Clin Endocrinol 36:338
Gelfand EW, Dosch H-M, Hastings D, Shore A (1979) Lithium: A modulator of cyclic AMP-dependent events in lymphocytes? Science 203:365–367
Gerdes H (1978) Lithium und Endokrinium. In: Frick P, Harnack G-A von, Martini GA, Prader A, Schoen R, Wolff HP (Hrsg) Ergebnisse der Inneren Medizin und Kinderheilkunde. Springer, Berlin Heidelberg New York, S 30–83
Lazarus JH, John R, Bennie EH, Chalmers RJ, Crockett G (1981) Lithium therapy and thyroid function: A long-term study. Psychol Med 11:85–92
Lindstedt G, Lundberg P-A, Tofft M, Åkesson HO, Öhman R (1973) Serum thyrotropin and hypothyroidism during lithium therapy. Clin Chim Acta 48:127–133
Müller-Oerlinghausen B (1977) 10 Jahre Lithium-Katamnese. Nervenarzt 49:483–493
Rosser R (1976) Thyrotoxicosis and lithium. Br J Psychiat 128:61–66
Shenkman L, Borkowsky W, Shopsin B (1980) Lithium as an immunologic adjuvant. Med Hypotheses 6:1–6
Shopsin B, Blum M, Gershon S (1969) Lithium-induced thyroid disturbance: Case report and review. Comprehensive Psychiatry 10:215–223
Wasilewski B, Steinböck H, Kohl R, Greil W, Bottermann P (1978) Schilddrüsenfunktion bei der Lithiumprophylaxe. Arzneimittel-Forsch/Drug Res 28:1297–1298
Wenzel KW, Meinhold H, Herpich M, Adlkofer F, Schleusener H (1974) TSH-Stimulationstest mit altersabhängigem TSH-Anstieg bei Normalpersonen. Klin Wochenschr 52:722–727
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Albrecht, J., Hopf, U. Humorale Autoimmunphänomene unter Langzeittherapie mit Lithium unter besonderer Berücksichtigung schilddrüsenspezifischer Autoantikörper. Klin Wochenschr 60, 1501–1504 (1982). https://doi.org/10.1007/BF01716102
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01716102