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Outcome of patients with lithium poisoning at a far-east poison center.
MedLine Citation:
PMID:  20630915     Owner:  NLM     Status:  In-Data-Review    
Introduction: Lithium is a popular medication for bipolar disorder, but very little work has been done to study Asian patients with lithium poisoning. Methods: A total of 21 out of 7140 poisoned patients were referred for management of lithium poisoning between 2000 and 2009. Patients were stratified according to blood lithium level, that is mild-to-moderate (<2.5 mEq/L) or severe (≥2.5 mEq/L) poisoning. Demographic, clinical, and laboratory data were obtained for analysis. Mortality rates were also analyzed. Results: There were no significant differences between both groups for the baseline variables such as poisoning patterns, age, sex, smoking habit, alcohol consumption, or medical history of diabetes mellitus or hypertension (p > 0.05). Patients with severe poisoning had a greater distribution of severe neurological symptoms (mild/moderate/ severe: 11.1%/44.4%/44.4% versus 58.35%/16.65%/8.3%, p < 0.05), cardiovascular symptoms (66.6% versus 16.6%, p < 0.05), and renal impairment (urea nitrogen/creatinine: 27.1 ± 17.8/ 1.9 ± 1.3 mg/dL versus 14.1 ± 7.1/ 1.3 ± 0.6 mg/dL, p < 0.05) than patients with mild-to-moderate poisoning. Most patients were treated with saline diuresis (9 patients [100%] with severe poisoning versus 9 patients [75.0%] with mild-to-moderate poisoning, p > 0.05). Hemodialysis was initiated in 2 (22.2%) of 9 and 1 (8.3%) of 12 patients with severe and mild-to-moderate poisoning, respectively (p > 0.05). The treatment was successful and all patients recovered without chronic sequelae. Thus, these favorable outcomes were comparable to the data from other international Poison Centers. Conclusions: Given the excellent outcomes of detoxification protocols, patients undergoing lithium therapy must be closely monitored for its toxicity and treated immediately in case of poisoning.
Yen-Ching Lee; Ja-Liang Lin; Shen-Yang Lee; Ching-Wei Hsu; Cheng-Hao Weng; Yu-Hui Chen; Chih-Wei Yang; Tzung-Hai Yen
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Publication Detail:
Type:  Journal Article     Date:  2010-07-14
Journal Detail:
Title:  Human & experimental toxicology     Volume:  30     ISSN:  1477-0903     ISO Abbreviation:  Hum Exp Toxicol     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-06-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9004560     Medline TA:  Hum Exp Toxicol     Country:  England    
Other Details:
Languages:  eng     Pagination:  528-34     Citation Subset:  IM    
Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital, Taipei, Taiwan, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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