Very Severe Self-Poisoning Lithium Carbonate Intoxication Causing a Myocardial Infarction
| Title: | Very Severe Self-Poisoning Lithium Carbonate Intoxication Causing a Myocardial Infarction |
|---|---|
| Authors: | Perrier, Arnaud; Martin, Pierre-Yves; Favre, Herve; Muller, Alex F.; Urban, Philippe; Chevrolet, Jean-Claude |
| Publisher: | Chest |
| Date Published: | September 01, 1991 |
| Reference Number: | 315 |
A case of severe lithium carbonate self-poisoning is described, presenting with a very high serum lithium level (14.6 mmol/L) on admission. Lengthy and repeated hemodialyses were required to lower lithemia to nontoxic ranges. As is usually reported, our patient had prolonged neurologic manifestations (coma, hyperreflexia, fluctuating focal signs) and developed hypotension, cardiovascular collapse, nephrogenic diabetes insipidus, and diarrhea. Other less common features were the occurrence of acute myocardial infarction without coronary artery lesions and thrombocytopenia. The possible pathogenic mechanisms are discussed. Hemodialysis and supportive intensive care treatment are commented upon. The final outcome was favorable, and the patient recovered completely.
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This translation by the NDI Foundation is to assist the lay reader. To provide a clear, accessible interpretation of the original article, we eliminated or simplified some technical detail and complicated scientific language. We concentrated our translation on those aspects of the article dealing directly with NDI. The NDI Foundation thanks the researchers for their work toward understanding and more effectively treating this disorder.
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These complications are expected. What was more unusual is the lithium intoxication also caused a decrease in the number of blood platelets and a myocardial infarction, which is a destruction of heart tissue.
Lithium salts are eliminated almost exclusively by the kidneys. Thus, to clear out the excess lithium, normal kidney function must be reestablished. In severe cases of lithium intoxication, as in this one, hemodialysis should be performed. The hemodialysis periods should be short and frequent. The authors' patient recovered.