리튬 복용으로 발생한 신성 요붕증과 횡문근융해증 1예
A Case of Lithium-Induced Nephrogenic Diabetes Insipidus and Rhabdomyolysis
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초록
저자들은 조울증으로 6년간 리튬 치료를 받던 중 신성 요붕증과 횡문근융해증이 발생한 환자에서 수액 치료와 리튬 중단과 thiazide, amiloride 투여로 호전된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
A 59-year-old woman was admitted to our hospital with polydipsia and general weakness. She had a 30-year history of bipolar disorder and was being treated with risperidone (4 mg/day) and lithium carbonate (1,200 mg/day). During her time in hospital, her urine output and serum osmolality increased, and her urine osmolality decreased. She was found to have myoglobulinuria, an elevated creatine kinase level, and abnormal renal function. Based on these findings, the patient was diagnosed with diabetes insipidus and rhabdomyolysis secondary to lithium therapy. After fluid therapy and the withdrawal of lithium, her clinical symptoms improved significantly. Her urine volume decreased gradually after treatment with amiloride. The effects of lithium on the muscle system are unknown. Hyperosmolarity caused by lithium-induced diabetes insipidus is considered a contributing factor in rhabdomyolysis. (Korean J Med 2012;82:367-370)
참고문헌 (10)
- Amdisen A, "Clinical features and management of lithium poisoning", Med Toxicol Adverse Drug Exp, 3, pp.18~32 (1988)
- Boton R, "Prevalence, pathogenesis, and treatment of renal dysfunction associated with chronic lithium therapy", Am J Kidney Dis, 10, pp.329~345 (1987)
- Unger J, "Rhabdomyolysis, acute renal failure endocrine alterations and neurological sequelae in a case of lithium selfpoisoning", Acta Clin Belg, 37, pp.216~223 (1982)
- Su KP, "Severe peripheral polyneuropathy and rhabdomyolysis in lithium intoxication: a case report", Gen Hosp Psychiatry, 21, pp.136~137 (1999)
- Singhal PC, "Rhabdomyolysis in the hyperosmolal state", Am J Med, 88, pp.9~12 (1990)
- Bateman AM, "Rhabdomyolysis associated with lithium-induced hyperosmolal state", Nephrol Dial Transplant, 6, pp.203~205 (1991)
- Lyles MR, "Deep venous thrombophlebitis associated with lithium toxicity", J Natl Med Assoc, 76, pp.633~634 (1984)
- Vikrant S, "Deep vein thrombosis complicating severe hypernatremia, rhabdomyolysis, and acute renal failure in a patient with untreated seizure disorder", Clin Exp Nephrol, 11, pp.88~91 (2007)
- Batlle DC, "Amelioration of polyuria by amiloride in patients receiving long-term lithium therapy", N Engl J Med, 312, pp.408~414 (1985)
- Kwon TH, "Altered expression of renal AQPs and Na(+) transporters in rats with lithium-induced NDI", Am J Physiol Renal Physiol, 279, pp.552~564 (2000)