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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2019
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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. |
format | Online Article Text |
id | pubmed-6751439 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
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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