Abstract
Lithium therapy has been associated with several endocrine disorders including thyroid dysfunction, diabetes insipidus, and hyperparathyroidism. While its suppressive effect on thyroid function is well known, it is very rare to observe lithium-induced hyperthyroidism especially in the pediatric population. Here, we describe a case of lithium-induced hyperthyroidism in an adolescent female with bipolar disorder. The patient is a 17-year-old female who was treated with lithium for bipolar disorder and presented with symptoms and laboratory findings consistent with hyperthyroidism. Since thyroid autoantibodies were negative, thyroid dysfunction was attributed to lithium toxicity. Indeed, her clinical and biochemical hyperthyroid state resolved after stopping lithium therapy. Lithium-associated hyperthyroidism can occur in the pediatric population. We propose close monitoring of thyroid hormone levels in children on lithium therapy.
Highlights
Lithium therapy has been associated with several endocrine disorders including thyroid dysfunction, diabetes insipidus, and hyperparathyroidism
We describe a case of lithium-induced hyperthyroidism in an adolescent female with bipolar disorder. e patient is a 17-year-old female who was treated with lithium for bipolar disorder and presented with symptoms and laboratory findings consistent with hyperthyroidism
It has been associated with several endocrine disorders including thyroid dysfunction, diabetes insipidus, and hyperparathyroidism
Summary
Bipolar disorders are common in adolescents, with a lifetime prevalence of 2.5% [1] and 0.1% in children aged 9–13 years [2]. Lithium is commonly used for the treatment of bipolar disorders in children and adolescents [3]. It has been associated with several endocrine disorders including thyroid dysfunction, diabetes insipidus, and hyperparathyroidism. Its suppressive effect on thyroid function is well known; in contrast, lithium-induced hyperthyroidism is rare with a prevalence in the range of between 1% and 1.7% in the adult population [4, 5]. E first case of thyrotoxicosis in a patient treated with lithium was reported in 1974 [6]. Hyperthyroidism in lithium-treated patients has been associated with diffuse goiter, toxic multinodular goiter, and painless thyroiditis [7]. Ere have not been any cases reported about lithium-induced hyperthyroidism in pediatric population. We are presenting an adolescent girl treated with lithium who presented with hyperthyroidism
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