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Lithium-Associated Hypercalcemia: Pathophysiology, Prevalence, Management

Meehan, Adrian David, 1973- (författare)
Örebro universitet, Institutionen för medicinska vetenskaper, Department of Geriatrics, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden
Udumyan, Ruzan, 1971- (författare)
Örebro universitet, Institutionen för medicinska vetenskaper, Clinical Epidemiology and Biostatistics
Kardell, Mathias, (författare)
Section of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden
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Landén, Mikael, (författare)
Section of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden: Sahlgrenska University Hospital, Gothenburg, Sweden
Järhult, Johannes, (författare)
Department of Surgery, Ryhov Hospital, Jönköping, Sweden
Wallin, Göran, 1952- (författare)
Örebro universitet, Institutionen för medicinska vetenskaper, Department of Surgery, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden
Jarhult, J. (författare)
Landen, M, (författare)
Karolinska Institutet
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Örebro universitet Institutionen för medicinska vetenskaper. (creator_code:org_t)
Göteborgs universitet Sahlgrenska akademin. Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi. 
2018
Engelska.
Ingår i: World Journal of Surgery. - 0364-2313. ; 42:2, s. 415-424
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • BACKGROUND: Lithium-associated hypercalcemia (LAH) is an ill-defined endocrinopathy. The aim of the present study was to determine the prevalence of hypercalcemia in a cohort of bipolar patients (BP) with and without concomitant lithium treatment and to study surgical outcomes for lithium-associated hyperparathyroidism.METHODS: Retrospective data, including laboratory results, surgical outcomes and medications, were collected from 313 BP treated with lithium from two psychiatric outpatient units in central Sweden. In addition, data were collected from 148 BP without lithium and a randomly selected control population of 102 individuals. Logistic regression was used to compare odds of hypercalcemia in these respective populations.RESULTS: The prevalence of lithium-associated hypercalcemia was 26%. Mild hypercalcemia was detected in 87 out of 563 study participants. The odds of hypercalcemia were significantly higher in BP with lithium treatment compared with BP unexposed to lithium (adjusted OR 13.45; 95% CI 3.09, 58.55; p = 0.001). No significant difference was detected between BP without lithium and control population (adjusted OR 2.40; 95% CI 0.38, 15.41; p = 0.355). Seven BP with lithium underwent surgery where an average of two parathyroid glands was removed. Parathyroid hyperplasia was present in four patients (57%) at the initial operation. One patient had persistent disease after the initial operation, and six patients had recurrent disease at follow-up time which was on average 10 years.CONCLUSION: The high prevalence of LAH justifies the regular monitoring of calcium homeostasis, particularly in high-risk groups. If surgery is necessary, bilateral neck exploration should be considered in patients on chronic lithium treatment. Prospective studies are needed.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

Nyckelord

primary hyperparathyroidism
bipolar disorder
therapy
parathyroidectomy
history
society
disease
era
hou m
1954
journal of neurology neurosurgery and psychiatry
v17
p250
henry cr
1990
surgery11th annual meeting of the american assoc of endocrine

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