Perioperative management of lithium in the patient undergoing pituitary surgery: a case report.
Richards, Emma Pankhania, Miran Thomas, Charlotte Jolly, Karan Ayuk, John Ahmed, Shahzada
Richards, Emma
Pankhania, Miran
Thomas, Charlotte
Jolly, Karan
Ayuk, John
Ahmed, Shahzada
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Affiliation
Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust
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Publication date
2022-05-08
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Abstract
Lithium is a psychotropic drug used primarily in the treatment of bipolar disorder. It is renally excreted and characteristically causes nephrogenic diabetes insipidus as an adverse drug reaction. Lithium also requires serum level monitoring as there is a narrow therapeutic window and untreated toxicity can result in neurological sequelae including drowsiness, coma, seizures, and ultimately death. We present the case of a 65-year old man admitted for pituitary surgery complicated by post-operative difficult fluid management and subsequent lithium toxicity. We highlight this rare situation and the need to be vigilant in the peri-operative period with any patients on lithium who undergo pituitary surgery.
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Richards E, Pankhania M, Thomas C, Jolly K, Ayuk J, Ahmed S. Perioperative management of lithium in the patient undergoing pituitary surgery: a case report. Br J Neurosurg. 2024 Aug;38(4):1042-1044. doi: 10.1080/02688697.2021.2010651. Epub 2022 May 8.
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