title: Outcome of patients with lithium poisoning at a far-east poison center.
abstract: BACKGROUND
  Lithium is a popular medication for bipolar disorder, but very little work has been done to study Asian patients with lithium poisoning.
  
  
  METHODS
  A total of 21 out of 7140 poisoned patients were referred for management of lithium poisoning between 2000 and 2009. Patients were stratified according to blood lithium level, that is mild-to-moderate (<2.5 mEq/L) or severe (≥2.5 mEq/L) poisoning. Demographic, clinical, and laboratory data were obtained for analysis. Mortality rates were also analyzed.
  
  
  RESULTS
  There were no significant differences between both groups for the baseline variables such as poisoning patterns, age, sex, smoking habit, alcohol consumption, or medical history of diabetes mellitus or hypertension (p > 0.05). Patients with severe poisoning had a greater distribution of severe neurological symptoms (mild/moderate/ severe: 11.1%/44.4%/44.4% versus 58.35%/16.65%/8.3%, p < 0.05), cardiovascular symptoms (66.6% versus 16.6%, p < 0.05), and renal impairment (urea nitrogen/creatinine: 27.1 ± 17.8/ 1.9 ± 1.3 mg/dL versus 14.1 ± 7.1/ 1.3 ± 0.6 mg/dL, p < 0.05) than patients with mild-to-moderate poisoning. Most patients were treated with saline diuresis (9 patients [100%] with severe poisoning versus 9 patients [75.0%] with mild-to-moderate poisoning, p > 0.05). Hemodialysis was initiated in 2 (22.2%) of 9 and 1 (8.3%) of 12 patients with severe and mild-to-moderate poisoning, respectively (p > 0.05). The treatment was successful and all patients recovered without chronic sequelae. Thus, these favorable outcomes were comparable to the data from other international Poison Centers.
  
  
  CONCLUSIONS
  Given the excellent outcomes of detoxification protocols, patients undergoing lithium therapy must be closely monitored for its toxicity and treated immediately in case of poisoning.
authors.affiliation: Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Yen-Ching
authors.initials: YC
authors.lastname: Lee
authors.forename: Ja-Liang
authors.initials: JL
authors.lastname: Lin
authors.forename: Shen-Yang
authors.initials: SY
authors.lastname: Lee
authors.forename: Ching-Wei
authors.initials: CW
authors.lastname: Hsu
authors.forename: Cheng-Hao
authors.initials: CH
authors.lastname: Weng
authors.forename: Yu-Hui
authors.initials: YH
authors.lastname: Chen
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Yang
authors.forename: Tzung-Hai
authors.initials: TH
authors.lastname: Yen
mesh_terms: D000208:Acute Disease; D001714:Bipolar Disorder / Q000188:drug therapy; D002908:Chronic Disease; D004231:Diuresis; D005202:Asia, Eastern / Q000453:epidemiology; D005260:Female; D005751:Gastric Lavage; D006801:Humans; D018020:Lithium Compounds / Q000097:blood / Q000506:poisoning*; D008297:Male; D008875:Middle Aged; D011039:Poison Control Centers; D011041:Poisoning / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000628:therapy; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D018020:Lithium Compounds; D012462:Saline Solution, Hypertonic