LITHIUM INDUCED HYPERTHYROIDISM: CASE REPORT

CH. Ramya Sri*, Mallika Kaza, Dr. K. Abbulu and G. Ramya Naidu

ABSTRACT

Introduction: Lithium is an integral drug used in the management of acute mania, unipolar and bipolar depression[1] and prophylaxis of bipolar disorders. Thyroid abnormalities associated with treatment lithium have been widely reported in medical literature to date.[2] These include goiter, hypothyroidism, hyperthyroidism and autoimmune thyroiditis. This current review explores the varied thyroid abnormalities frequently encountered among patients on lithium therapy and their management[3], since lithium is still a fundamental and widely drug used in psychiatry and Internal Medicine. Discussion: A 34-year-old woman with bipolar epilepsy disorder of 1- year duration was admitted for acute onset of amenorrhea, depression and polydipsia on admission, the patient was depressed and restless and loss of interest in surrounding. She is having the history of chronic liver disease. She had a coarse tremor in her upper limbs and brisk tendon reflexes but no ataxia. The patient had been prescribed a number of medications to treat recurrent auditory. These included multivitamins and B complex.). A urine toxicology screen was positive for benzodiazepine, as was expected (the patient had received lorazepam at another hospital). Conclusions: Thyroid function tests (serum thyroid stimulating hormone, free thyroid hormones-T4and triiodothyronine [T3] concentrations and thyroid auto-antibodies) and More frequent assessment of thyroid function status and size during the course of therapy is recommended among middle aged females (≥50 years), patients with a family history of thyroid disease and those positive for thyroid auto-antibodies (anti-thyroid peroxidase and TSH receptor antibodies). By the withdrawal of the drug the condition o9f the patient was improved.

Keywords: Thyroid abnormalities, Hyperthyroidism, Thyroid autoimmunity.