Hyperparathyroidism associated with treatment of manic-depressive disorders by lithium.
OBJECTIVE
To clarify the association between treatment of affective psychiatric disorders with lithium, and the development of secondary hyperparathyroidism.


METHODS
Retrospective review of medical records, 1973-89.


METHODS
17 patients with affective psychiatric disorders who were treated with lithium (n = 6) or with tricyclic antidepressant, or neuroleptic, drugs (n = 11) all of whom were operated on for hyperparathyroidism.


METHODS
Duration of lithium therapy and parathyroid histology.


RESULTS
Parathyroid hyperplasia was present in 5 patients who had taken lithium during a median period of 13 years. A parathyroid adenoma was found in one patient treated with lithium for three years. Ten of the 11 patients who had been treated with tricyclic antidepressant, or neuroleptic drugs had a parathyroid adenoma and the remaining one had an adenoma as an underlying cause of hyperparathyroidism.


CONCLUSIONS
Hyperparathyroidism in patients who have undergone long term treatment with lithium is associated with parathyroid hyperplasia. This indicates that lithium may exert a chronic stimulus that results in secondary hyperparathyroidism.
Department of Surgery, Huddinge University Hospital, Sweden.
J
J
Nordenström
K
K
Strigård
L
L
Perbeck
J
J
Willems
M
M
Bågedahl-Strindlund
J
J
Linder
D000236:Adenoma / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D001714:Bipolar Disorder / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D006965:Hyperplasia / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D008094:Lithium / Q000009:adverse effects*; D010280:Parathyroid Glands / Q000473:pathology; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology
D010281:Parathyroid Hormone; D008094:Lithium