Hypercalcemia and diabetes insipidus in a patient previously treated with lithium.
BACKGROUND
A 65-year-old woman presented with decreased oral intake, a reduced level of consciousness, hypercalcemia and hypernatremia. She had previously received lithium for 20 years for a schizoaffective disorder, but this treatment had been discontinued 3 years before presentation.


METHODS
Physical examination, laboratory studies including measurement of serum calcium and parathyroid hormone levels, measurement of urine and serum osmolalities before and after desmopressin administration, blood and urine cultures, and a CT scan of the abdomen.


METHODS
Urosepsis, dehydration, kidney stone disease, hyperparathyroidism, and nephrogenic diabetes insipidus.


RESULTS
Hydration, antibiotics, intravenous pamidronate for rapid control of hypercalcemia, parathyroidectomy, surgical removal of the large kidney stones, a low-protein and low-sodium diet, and initiation of treatment with a thiazide diuretic.
Khairallah
Walid
W
Division of Endocrinology, American University of Beirut, Lebanon.
Fawaz
Ahmad
A
Brown
Edward M
EM
El-Hajj Fuleihan
Ghada
G
D000368:Aged; D018500:Diabetes Insipidus, Nephrogenic / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D006961:Hyperparathyroidism / Q000139:chemically induced* / Q000150:complications / Q000601:surgery; D007669:Kidney Calculi / Q000139:chemically induced* / Q000150:complications / Q000601:surgery; D016651:Lithium Carbonate / Q000008:administration & dosage / Q000009:adverse effects*; D008134:Long-Term Care; D016105:Parathyroidectomy / Q000379:methods; D018570:Risk Assessment; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
D016651:Lithium Carbonate