Clinical features and literature review of 20 patients with lithium carbonate poisoning
Tang Guo
Zhang Tianshan
Yang Ying
Yang Sha
Jiang Zhen
Yao Rong
Abstract：Objective To analyze and summarize the clinical features of lithium carbonate poisoning in 20 patients.Methods We retrospectively analyzed the general information,clinical manifestation,treatment history,and prognosis of patients admitted to the Emergency Department of West China Hospital of Sichuan University from April 1,2018 to April 30,2022.According to the severity of the patient′s condition during hospitalization,they were divided into the Intensive Care Unit(ICU)group and the non-ICU group.Univariate analysis was used to screen potential risk factors for ICU admission.Results A total of 20 patients with lithium carbonate poisoning were included in the study,with ages ranging from 16 to 67 years and a mean age of 18.5(16,21)years.All 20 patients suffered from psychiatric disorders,among which 12 were diagnosed with bipolar disorder(12/20),6 with depression(6/20),1 with comorbid bipolar disorder and depression(1/20),and 1 with mania(1/20).The clinical manifestations of lithium carbonate poisoning were predominantly neurological and gastrointestinal symptoms,2 exhibited cardiotoxicity(2/20),and 1 showed renal impairment(1/20).Twelve patients received hemodialysis treatment(12/20),and 3 required admission to the ICU for ventilatory support(3/20).Compared to the patients not admitted to the ICU,those admitted to the ICU had significantly lower absolute eosinophil counts(P =0.023),but the higher respiratory rates(P = 0.003),diastolic blood pressure(P = 0.014),absolute monocyte counts(P = 0.029),indirect bilirubin levels(P = 0.013),and cystatin C(P = 0.045).Following treatment,all the patients improved and were discharged from the hospital(20/20).Conclusions Lithium carbonate poisoning is most commonly observed in the patients with a history of mental illness,particularly women and adolescents.The clinical manifestations primarily involve the nervous and digestive systems,including heart damage and renal dysfunction.Reduced absolute eosinophil counts and elevated respiratory rates,diastolic blood pressure,absolute monocyte counts,indirect bilirubin,and cystatin C might serve as risk factors for ICU admission.
Keywords：Lithium carbonatePoisoningBlood concentrationPrognosisBlood purification therapyIntensive Care Unit(ICU)
Publication Date：2024-04-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 350-356 )