Lithium and Risk of Hypercalcemia & Hyperparathyroidism
This post will focus on:
-
Differentiate Lithium associated hypercalcemia/hyperparathyroidism from primary hyperparathyroidism.
-
Symptoms of hypercalcemia.
-
Monitoring guideline.
LITHIUM ASSOCIATEDHYPER-CALCEMIA/HYPER-PARATHYROIDISM |
PRIMARYHYPER-PARATHYROIDISM |
|
Serum Calcium |
HIGH (mild- moderate elevation) + |
HIGH (greater elevation) +++ |
iPTH |
HIGH (high normal- mild elevation) + |
HIGH (greater elevation) +++ |
Phosphate |
Normal |
LOW |
Magnesium |
HIGH + |
Normal |
Urine Calcium |
LOW |
HIGH |
SYMPTOMATIC HYPERCALCEMIA SYMPTOMS:
(a) STONES:
-
Nephrolithiasis.
-
Renal dysfunction.
(b) BONES:
-
Osteoporosis.
(c) GROANS:
-
Peptic ulcers.
-
Pancreatitis.
(d) MOANS:
-
Behavior and mood changes.
MONITORING GUIDELINES:
According to 2009 International Society for Bipolar Disorders guidelines:
-
baseline calcium level
-
Followup level at 6 months, and
-
Annually after that.
Source:
- Am J Psychiatry. 2015 Jan;172(1):12-5.
Please do post your questions or comments below.

Dr. Harvinder Singh, M.D. (Admin)

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