Pharmaceutica Analytica Acta

Abstract

Multiple Endocrine-Related Complications of Lithium Therapy in a Patient with Low-Grade Meningioma

Sajjad Hussain (MBBS, MRCP, FCPS)1, Abdullah Shamshad (MBBS, MRCP, FCPS)2, Talha Rauf (MBBS, RMP)3, Muhammad Zeeshan Zafar (Pharm-D, MPhil, RPh)4*

Lithium is a first-line treatment for bipolar disease. It is not only associated with thyroid dysfunction but also with Primary Hyper Para Thyroidism (PHPT), nephrogenic diabetes insipidus, and an increased risk of end-stage renal disease. An elderly female patient on long-term lithium for ‘bipolar disorder’ presented in an acute confusional state with hypercalcemia and renal impairment. Further investigations confirmed PHPT, euthyroid goitre, and medullary nephrocalcinosis. Following a Para thyroidectomy, she developed an acute neurological event. A Computed Tomography (CT) scan of the head demonstrated a large meningioma. Following resection of the meningioma, she developed diabetes insipidus and orofacial dyskinesia, probably related to lithium therapy. Prolonged respiratory support in intensive care settings necessitated a tracheostomy by an open approach, due to the goitre, which was also associated with lithium therapy. This case illustrates the spectrum of endocrine related complications from lithium use and the need for biochemical monitoring in patients on long-term treatment

Published Date: 2024-07-31; Received Date: 2024-07-02