Lithium Toxicity Associated with a Trichobezoar
Authors: Denyse Thornley-Brown, John H. Galla, Phillip D. Williams, K. Sashi Kant, Mitchell Rashkin
Journal: Annals of Internal Medicine (1992)

Brief Reports1 May 1992Lithium Toxicity Associated with a TrichobezoarDenyse Thornley-Brown, MD, John H. Galla, MD, Phillip D. Williams, MD, K. Sashi Kant, MD, Mitchell Rashkin, MDDenyse Thornley-Brown, MDSearch for more papers by this author, John H. Galla, MDSearch for more papers by this author, Phillip D. Williams, MDSearch for more papers by this author, K. Sashi Kant, MDSearch for more papers by this author, Mitchell Rashkin, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-116-9-739 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptWe present an unusual case of lithium toxicity characterized by recurrently elevated serum lithium levels despite adequate hemodialysis.Case ReportA 47-year-old woman presented in an unresponsive state to the emergency department of the University of Cincinnati Hospital. She had a history of a bipolar disorder, keratosis follicularis, and a seizure disorder. Medications included tranylcypromine sulfate, 45 mg daily; benztropine mesylate, 1 mg daily; carbamazepine, 200 mg thrice daily; perphenazine, 16 mg thrice daily; lorazepam; and vitamin A. Lithium carbonate (Litho-bid, CIBA Pharmaceutical, Edison, New Jersey) had been discontinued 1 year before presentation because of an adverse skin reaction. On...References1. Goodnick P, Fieve R, Meltzer H, and Dunner D. Lithium elimination half-life and duration of therapy. Clin Pharmacol Ther. 1981; 29:47-50. CrossrefMedlineGoogle Scholar2. Singer I. Lithium and the kidney. Kid Int. 1981;19:374-87. CrossrefMedlineGoogle Scholar3. Amdisen A. Monitoring of lithium treatment through determination of lithium concentration. Dan Med Bull. 1975;22:277-91. MedlineGoogle Scholar4. Groth U, Prellwitz W, and Jahnchen E. Estimation of pharmacokinetic parameters of lithium from saliva and urine. Clin Pharmacol Ther. 1974;16:490-8. CrossrefMedlineGoogle Scholar5. Hansen H and Amdisen A. Lithium intoxication. Q J Med. 1978;47:123-44. MedlineGoogle Scholar6. Jaeger A, Sauder P, Kopferschmitt J, and Jaegle M. Toxicokinetics of lithium intoxication treated by hemodialysis. J Toxicol Clin Toxicol. 1985-86;23:501-17. CrossrefMedlineGoogle Scholar7. Jacobsen D, Aasen G, Frederichsen P, and Eisenga B. Lithium intoxication: pharmacokinetics during and after terminated hemodialysis in acute intoxications. J Toxicol Clin Toxicol. 1987;25:81-94. CrossrefMedlineGoogle Scholar8. DeBakey M and Ochsner A. Bezoars and concretions: a comprehensive review of the literature with an analysis of 303 collected cases and a presentation of 8 additional cases. Surgery. 1938;4:934-963; 1939; 5:132-60. Google Scholar9. Bogacz K and Caldron P. Enteric-coated aspirin bezoar: elevation of serum salicylate level by barium study. Am J Med. 1987;83:783-6. CrossrefMedlineGoogle Scholar10. Ray M, Radin D, Condie J, Halls J, and Padin D. Charcoal bezoar. Small-bowel obstruction secondary to amitriptyline overdose therapy. Dig Dis Sci. 1988;33:106-7. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Denyse Thornley-Brown, MD; John H. Galla, MD; Phillip D. Williams, MD; K. Sashi Kant, MD; Mitchell Rashkin, MDFrom the University of Cincinnati Medical Center, Cincinnati, Ohio. For current author addresses, see end of text. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDelayed Lithium Reintoxication in a Case of Severe Multidrug Intoxication: A Case StudyOpioid Overdose and Serotonin Syndrome due to Gastric Bezoar in a Woman with Autism and Pica BehaviourLithium PoisoningMiscellaneous Diseases of the StomachExtracorporeal Treatment for Lithium PoisoningGastric Electrical Stimulation for the Treatment of Obesity: From Entrainment to Bezoars—A Functional ReviewManagement of Lithium ToxicityTrichobezoars in TrichotillomaniaApproach to the poisoned patientBezoars and Foreign Bodies of the StomachLithiumLithium 1 May 1992Volume 116, Issue 9 Page: 739-740 Keywords Carbonates Emergency department Epilepsy Hypertension Nephrology Pulmonary diseases Skin reaction Sulfates Toxicity Vitamin A ePublished: 1 December 2008 Issue Published: 1 May 1992 PDF downloadLoading ...