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Three Patients with Lithium-Associated Hyperparathyroidism: Literature Review Regarding Medical and Surgical Management

Lithium (Li) carbonate has been established as a mood stabilizer and an efficacious treatment for bipolar disorder since its discovery by Dr. John Cade in 1948. Li interacts significantly with organ systems and endocrine pathways. One of the most challenging side effects of Li to manage is its effec...

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Autores principales: Hanna, Ramy M., Hasnain, Huma, Sangalang, Michelle D., Han, Jennifer, Arasu, Aarthi, Arman, Farid, Barsoum, Marina, Poa, Hyunah, Rastogi, Anjay, Harari, Avital
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751439/
https://www.ncbi.nlm.nih.gov/pubmed/31559266
http://dx.doi.org/10.1159/000502399
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author Hanna, Ramy M.
Hasnain, Huma
Sangalang, Michelle D.
Han, Jennifer
Arasu, Aarthi
Arman, Farid
Barsoum, Marina
Poa, Hyunah
Rastogi, Anjay
Harari, Avital
author_facet Hanna, Ramy M.
Hasnain, Huma
Sangalang, Michelle D.
Han, Jennifer
Arasu, Aarthi
Arman, Farid
Barsoum, Marina
Poa, Hyunah
Rastogi, Anjay
Harari, Avital
author_sort Hanna, Ramy M.
collection PubMed
description Lithium (Li) carbonate has been established as a mood stabilizer and an efficacious treatment for bipolar disorder since its discovery by Dr. John Cade in 1948. Li interacts significantly with organ systems and endocrine pathways. One of the most challenging side effects of Li to manage is its effect on the parathyroid glands. Dysregulation of parathyroid signaling due to Li results in hypercalcemia due to increased vitamin D<sub>3</sub> generation, increased calcium absorption from the gut, and bone resorption, occasionally resulting in concomitant hypercalciuria. However, hypercalciuria is not a definitive feature for hyperparathyroidism, and normal calcium excretion might be seen in these patients. Hypercalcemia may also result from volume contraction and decreased renal clearance, which are commonly seen in these patients. Anatomically the parathyroid abnormalities can present as single or multiglandular disease. We report 3 cases where the patients developed multiple side effects of Li therapy as well as hypercalcemia due to hyperparathyroidism. The literature is reviewed with regard to medical and surgical management of Li-associated hyperparathyroidism in the context of these 3 presented cases.
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spelling pubmed-67514392019-09-26 Three Patients with Lithium-Associated Hyperparathyroidism: Literature Review Regarding Medical and Surgical Management Hanna, Ramy M. Hasnain, Huma Sangalang, Michelle D. Han, Jennifer Arasu, Aarthi Arman, Farid Barsoum, Marina Poa, Hyunah Rastogi, Anjay Harari, Avital Case Rep Nephrol Dial Case Report Lithium (Li) carbonate has been established as a mood stabilizer and an efficacious treatment for bipolar disorder since its discovery by Dr. John Cade in 1948. Li interacts significantly with organ systems and endocrine pathways. One of the most challenging side effects of Li to manage is its effect on the parathyroid glands. Dysregulation of parathyroid signaling due to Li results in hypercalcemia due to increased vitamin D<sub>3</sub> generation, increased calcium absorption from the gut, and bone resorption, occasionally resulting in concomitant hypercalciuria. However, hypercalciuria is not a definitive feature for hyperparathyroidism, and normal calcium excretion might be seen in these patients. Hypercalcemia may also result from volume contraction and decreased renal clearance, which are commonly seen in these patients. Anatomically the parathyroid abnormalities can present as single or multiglandular disease. We report 3 cases where the patients developed multiple side effects of Li therapy as well as hypercalcemia due to hyperparathyroidism. The literature is reviewed with regard to medical and surgical management of Li-associated hyperparathyroidism in the context of these 3 presented cases. S. Karger AG 2019-08-20 /pmc/articles/PMC6751439/ /pubmed/31559266 http://dx.doi.org/10.1159/000502399 Text en Copyright © 2019 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Case Report
Hanna, Ramy M.
Hasnain, Huma
Sangalang, Michelle D.
Han, Jennifer
Arasu, Aarthi
Arman, Farid
Barsoum, Marina
Poa, Hyunah
Rastogi, Anjay
Harari, Avital
Three Patients with Lithium-Associated Hyperparathyroidism: Literature Review Regarding Medical and Surgical Management
title Three Patients with Lithium-Associated Hyperparathyroidism: Literature Review Regarding Medical and Surgical Management
title_full Three Patients with Lithium-Associated Hyperparathyroidism: Literature Review Regarding Medical and Surgical Management
title_fullStr Three Patients with Lithium-Associated Hyperparathyroidism: Literature Review Regarding Medical and Surgical Management
title_full_unstemmed Three Patients with Lithium-Associated Hyperparathyroidism: Literature Review Regarding Medical and Surgical Management
title_short Three Patients with Lithium-Associated Hyperparathyroidism: Literature Review Regarding Medical and Surgical Management
title_sort three patients with lithium-associated hyperparathyroidism: literature review regarding medical and surgical management
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751439/
https://www.ncbi.nlm.nih.gov/pubmed/31559266
http://dx.doi.org/10.1159/000502399
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