Skip to main content
Erschienen in: Notfall +  Rettungsmedizin 3/2015

01.05.2015 | Kasuistiken

A case of lithium toxicity with significant QT interval prolongation

verfasst von: Dr. med. T.K. Becker, MD, H. Hariri, MD

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 3/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

Lithium toxicity has been associated with electrocardiographic abnormalities, such as QT interval prolongation.

Case report

An unresponsive patient with a history of alcohol abuse and recently diagnosed bipolar disorder was brought to the emergency department. An elevated lithium level of 4.7 mmol/L was found. The corrected QT interval was significantly prolonged at 727 ms. The patient was dialyzed and recovered fully.

Discussion

This case illustrates the importance of a systematic evaluation of all patients who may have been exposed to a toxic ingestion.
Literatur
1.
Zurück zum Zitat Bealer SL, Little JG (2013) Seizures following hippocampal kindling induce QT interval prolongation and increased susceptibility to arrhythmias in rats. Epilepsy Res 105:216–219CrossRefPubMed Bealer SL, Little JG (2013) Seizures following hippocampal kindling induce QT interval prolongation and increased susceptibility to arrhythmias in rats. Epilepsy Res 105:216–219CrossRefPubMed
2.
Zurück zum Zitat Becker TK, Yeung SJ (2010) Drug-induced QT interval prolongation in cancer patients. Oncol Rev 4:223–232CrossRef Becker TK, Yeung SJ (2010) Drug-induced QT interval prolongation in cancer patients. Oncol Rev 4:223–232CrossRef
3.
Zurück zum Zitat Can A, Schulze TG, Gould TD (2014) Molecular actions and clinical pharmacogenetics of lithium therapy. Pharmacol Biochem Behav 123:3–16CrossRefPubMed Can A, Schulze TG, Gould TD (2014) Molecular actions and clinical pharmacogenetics of lithium therapy. Pharmacol Biochem Behav 123:3–16CrossRefPubMed
4.
Zurück zum Zitat Eyer F, Pfab R, Felgenhauer N et al (2006) Lithium poisoning: pharmacokinetics and clearance during different therapeutic measures. J Clin Psychopharmacol 26:325–330CrossRefPubMed Eyer F, Pfab R, Felgenhauer N et al (2006) Lithium poisoning: pharmacokinetics and clearance during different therapeutic measures. J Clin Psychopharmacol 26:325–330CrossRefPubMed
5.
Zurück zum Zitat Howland RH (2007) Lithium: underappreciated and underused? J Psychosoc Nurs Ment Health Serv 45:13–17 Howland RH (2007) Lithium: underappreciated and underused? J Psychosoc Nurs Ment Health Serv 45:13–17
6.
Zurück zum Zitat Jacob AI, Hope RR (1979) Prolongation of the Q-T interval in lithium toxicity. J Electrocardiol 12:117–119CrossRefPubMed Jacob AI, Hope RR (1979) Prolongation of the Q-T interval in lithium toxicity. J Electrocardiol 12:117–119CrossRefPubMed
7.
Zurück zum Zitat La Rocca R, Foschi A, Preston NM et al (2012) QT interval prolongation and bradycardia in lithium-induced nephrogenic diabetes insipidus. Int J Cardiol 162:e1–e2CrossRef La Rocca R, Foschi A, Preston NM et al (2012) QT interval prolongation and bradycardia in lithium-induced nephrogenic diabetes insipidus. Int J Cardiol 162:e1–e2CrossRef
8.
Zurück zum Zitat Mamiya K, Sadanaga T, Sekita A et al (2005) Lithium concentration correlates with QTc in patients with psychosis. J Electrocardiol 38:148–151CrossRefPubMed Mamiya K, Sadanaga T, Sekita A et al (2005) Lithium concentration correlates with QTc in patients with psychosis. J Electrocardiol 38:148–151CrossRefPubMed
9.
Zurück zum Zitat Mateer JR, Clark MR (1982) Lithium toxicity with rarely reported ECG manifestations. Ann Emerg Med 11:208–211CrossRefPubMed Mateer JR, Clark MR (1982) Lithium toxicity with rarely reported ECG manifestations. Ann Emerg Med 11:208–211CrossRefPubMed
10.
Zurück zum Zitat Mowry JB, Spyker DA, Cantilena LR Jr et al (2013) 2012 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 30th annual report. Clin Toxicol (Phila) 51:949–1229CrossRef Mowry JB, Spyker DA, Cantilena LR Jr et al (2013) 2012 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 30th annual report. Clin Toxicol (Phila) 51:949–1229CrossRef
11.
Zurück zum Zitat Offerman SR, Alsop JA, Lee J et al (2010) Hospitalized lithium overdose cases reported to the California Poison Control System. Clin Toxicol (Phila) 48:443–448CrossRef Offerman SR, Alsop JA, Lee J et al (2010) Hospitalized lithium overdose cases reported to the California Poison Control System. Clin Toxicol (Phila) 48:443–448CrossRef
Metadaten
Titel
A case of lithium toxicity with significant QT interval prolongation
verfasst von
Dr. med. T.K. Becker, MD
H. Hariri, MD
Publikationsdatum
01.05.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 3/2015
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-015-0008-x

Weitere Artikel der Ausgabe 3/2015

Notfall +  Rettungsmedizin 3/2015 Zur Ausgabe

Mitteilungen der agswn

Mitteilungen der agswn

Mitteilungen des DBRD

Mitteilungen des DBRD

Mitteilungen des GRC

Mitteilungen des GRC