Nephrogenic diabetes insipidus in a lethargic lithium-treated patient.
We report on a patient who developed severe lithium-induced nephrogenic diabetes insipidus (NDI) and neurotoxicity, despite recommended serum lithium levels. Hydrochlorothiazide and indomethacin appeared effective antipolyuric drugs, which led to a normalization of serum osmolality. After re-initiating lithium therapy, with lithium levels around 0.3 mmol/l, recurrence of NDI or neurotoxicity was not observed, despite discontinuation of indomethacin and hydrochlorothiazide. Together with hypothyroidism, NDI and neurotoxicity must be considered in lethargic lithium-treated patients.
Meinardi
J R
JR
Department of Internal Medicine, Martini Ziekenhuis (Locatie van Swieten), Groningen, Netherlands.
Donders
S H
SH
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects; D018500:Diabetes Insipidus, Nephrogenic / Q000097:blood / Q000139:chemically induced*; D006801:Humans; D008094:Lithium / Q000097:blood; D016651:Lithium Carbonate / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D019964:Mood Disorders / Q000188:drug therapy*; D012894:Sleep Stages
D000928:Antidepressive Agents; D016651:Lithium Carbonate; D008094:Lithium