급성신부전을 나타낸 Lithium 중독 1예 = A Case of Lithium Intoxication with Acute Kidney Injury

다국어 초록 (Multilingual Abstract)

We report a case of 48 years-old male bipolar disorder patient with acute kidney injury due to severe lithium intoxication. He was taking lithium 300 mg per day but suddenly ingested all 30 tablets of lithium 300 mg (total 9,000 mg) at one sitting to commit suicide. On his arrival at the emergency room, the serum lithium concentration was 12.47 mEq/L. Thereafter he was treated with hemodialysis four times for 4-4.5 hour per session and recovered without any prominent sequela. The serum lithium level checked 9 days after hemodialysis was 0.1 mEq/L. Therefore we suggest that clinicians should consider such a strategy as mandatory hemodialysis in a patient with severe kidney intoxication when serum lithium concentrations are very high or rapidly increasing.

국문 초록 (Abstract)

저자들은 자살목적으로 lithium을 과량 복약하고 응급실로 내원한 환자의 혈액학적 검사 및 임상적 소견으로 급성신부전을 진단하여, 초기에 적극적으로 혈액 투석을 통해 lithium을배출시켜 유의한 후유증 없이 회복된 양극성 장애 환자의 사례를 보고하였다. 따라서, 정신건강의학과 의사는 lithium 복용 환자와 보호자에게 lithium 중독 가능성에 대한충분한 사전 설명과 교육을 실시하고, 심각한 lithium 중독 환자의 경우에 혈액투석과 같은 적극적인 내과적 치료를 시행해야 한다.

참고문헌 (Reference)

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