Acute Lithium Administration Impairs the Action of Parathyroid Hormone on Rat Renal Calcium, Magnesium and Phosphate Transport*

Carney, Shane; Jackson, Peggy

doi:10.1111/j.1440-1681.1998.tb02155.x

Cited by 12 publications

(4 citation statements)

References 25 publications

(1 reference statement)

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“…Antagonism of cations [28,29] Li + competitively antagonizes cations at calcium receptor at several locations-kidney, bone and parathyroid gland-causing acute hypercalcemia and hyper-magnesemia ↑ Set point or reset "calci-stat" [4,12,30,31] Li + antagonizes calcium sensing receptor (CASR) causing a shift in inhibitory set point for PTH secretion, which then requires a higher levels of calcium level to block PTH secretion. This results in an overproduction of PTH despite elevated serum calcium levels Mitogenic action [16,32,33] Li + exacerbates a pre-existing adenoma or PHPT-this occurs especially in patients presenting with psychiatric symptoms-the lithium therapy worsens hypercalcemia by promoting PTH overproduction.…”

Section: Mechanism Of Action Explanatationmentioning

confidence: 99%

Lithium Associated Hyperparathyroidism: An Evidence Based Surgical Approach

Ballehaninna¹,

Nguyen²,

Chamberlain³

2011

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Background: Long-term lithium use in psychiatric patients may lead to lithium associated hyperparathyroidism (LAH). Although anecdotal case reports have appeared, an evidence based algorithm for management of LAH is lacking. Methods: A comprehensive literature search was performed using PubMed with keywords; "lithium" "hypercalcemia" "hyperparathyroidism" "sestamibi" "intra-operative parathyroid hormone (IOPTH) monitoring" "parathyroidectomy" and "medical management". All English language publications addressing etiology and clinical management issues concerning LAH were critically analyzed. Results: Lithium associated hyperparathyroidism occurs in 4.3% -6.3% of chronic lithium users compared to the general population which has an incidence of 0.5% -1%. 194 cases of LAH have been reported which includes 10 patients (5%) treated medically and 170 patients (88%) who underwent parathyroidectomy. No details were available for 14 patients (7%). Among parathyroidectomy patients, 104 (59%) had adenomatous disease and 66 (39%) had multiglandular hyperplasia. Preoperative localization studies were utilized in only 22 patients (13%) and IOPTH monitoring was reported in only 3 studies (32 patients, 19%). Among surgical patients, bilateral neck exploration (BNE) was the most common approach performed in 162 patients (95%); focused neck exploration was utilized in only 8 patients (5%). Parathyroidectomy normalized LAH biochemical changes in nearly all patients (90% -97%) in the early post-operative period, but recurrent hyperparathyroidism occurred in 8% -42% of patients. Conclusion: LAH is an under appreciated and poorly understood endocrine disorder. LAH has a higher incidence of multiglandular disease and bilateral neck exploration is mandatory in majority for disease control. Nonsurgical approaches may be useful in select patients on short-term lithium therapy.

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Section: Mechanism Of Action Explanatationmentioning

confidence: 99%

Lithium Associated Hyperparathyroidism: An Evidence Based Surgical Approach

Ballehaninna¹,

Nguyen²,

Chamberlain³

2011

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“…[49] Ayrıca sıçanlarda lityumun böbrekte PTH'un iyon transportu üzerine etkilerini baskıladığı gösterilmiştir. [50] Bu etki lityumun siklik adenozin monofosfat (cAMP) oluşumunu baskılaması sonucu gelişmektedir.…”

Section: Mekanizmasıunclassified

Lityumun Metabolik Yan Etkileri

Eker¹,

Eker²

2014

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry

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Lithium is an alkaline ion being used since 19th century. After its widespread use in psychiatric disorders, observed side effects caused skepticism about its therapeutic efficacy. Despite several disadvantages, lithium is one of the indispensible drugs used in affective disorders, especially in bipolar disorder. It became a necessity for physicians to recognize its side effects since lithium is still accepted as a gold standard in the treatment of bipolar disorder. Adverse effects of chronic administration of lithium on several organ systems are widely known. In this article metabolic effects of lithium on thyroid and parathyroid glands, body mass index and kidneys will be discussed along with their mechanisms, clinical findings, possible risk factors and treatment. One of the most common side effect of lithium is hypothyroidism. It has the same clinical and biochemical properties as primary hypothyroidism and observed as subclinical hypothyroidism in the first place. Hypothyroidism, even its subclinical form, may be associated with non-response or inadequate response and is indicated as a risk factor for development of rapid cycling bipolar disorder. Therefore, hypothyroidism should be screened no matter how severe it is and should be treated with thyroid hormone in the presence of clinical hypothyroidism. Weight gain due to lithium administration disturbs the compliance to treatment and negatively affects the course of the illness. Increased risk for diabetes, hypertension, ischemic heart disease and stroke because of weight gain constitute other centers of problem. Indeed, it is of importance to determine the risk factors before treatment, to follow up the weight, to reorganize nutritional habits and to schedule exercises. Another frequent problematic side effect of lithium treatment is renal dysfunction which clinically present as nephrogenic diabetes insipidus with the common symptoms of polyuria and polydipsia. Nephrogenic diabetes insipidus develops because of urinary concentration defects due to the detrimental effects of lithium on re-absorption of water and sodium at the level of collector tubules. Close screening of renal functions is very important in the prevention of renal damage during treatment with lithium. Moreover, it is also of importance to screen serum lithium levels as lithium intoxication episodes may increase the risk of renal failure. As a conclusion lithium still preserves its indispensability in affective disorders. Clinicians should have current knowledge about the side effects of lithium and take preventive measures to apply such an important treatment to the patients.

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“…[220][221][222][223][224] Other studies are concerned with the parathyroid glands and control of calcium and magnesium balance and bone metabolism. [225][226][227]…”

Section: E Lithium and Endocrine Glandsmentioning

confidence: 99%

“…There is dispute as to whether this is actually a feature of lithium itself or whether the recovery process from the mood disorder leads to improved nutrition or reduced activity. A number of studies have tried to consider the endocrine features of this weight gain. , Some of these have also considered the fluid and electrolyte changes which may be related to atrial natriuretic peptide. − Other studies are concerned with the parathyroid glands and control of calcium and magnesium balance and bone metabolism. − …”

Section: E Lithium and Endocrine Glandsmentioning

confidence: 99%

Inorganic Pharmacology of Lithium

Birch¹

1999

Chem. Rev.

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Acute Lithium Administration Impairs the Action of Parathyroid Hormone on Rat Renal Calcium, Magnesium and Phosphate Transport*

Cited by 12 publications

References 25 publications

Lithium Associated Hyperparathyroidism: An Evidence Based Surgical Approach

Lithium Associated Hyperparathyroidism: An Evidence Based Surgical Approach

Lityumun Metabolik Yan Etkileri

Inorganic Pharmacology of Lithium

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