The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Lithium-Induced Nephrogenic Diabetes Insipidus and Rhabdomyolysis

리튬 복용으로 발생한 신성 요붕증과 횡문근융해증 1예

  • Moh, In-Ho (Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University College of Medicine) ;
  • Lee, Young-Ki (Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University College of Medicine) ;
  • Son, Seung-Yeon (Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University College of Medicine) ;
  • Sin, Yun-Ho (Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University College of Medicine) ;
  • Lee, Seung-Min (Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University College of Medicine) ;
  • Lee, Dong-Hun (Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University College of Medicine) ;
  • Noh, Jung-Woo (Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University College of Medicine)
  • 모인호 (한림대학교 의과대학 내과학교실, 신장연구소) ;
  • 이영기 (한림대학교 의과대학 내과학교실, 신장연구소) ;
  • 손승연 (한림대학교 의과대학 내과학교실, 신장연구소) ;
  • 신윤호 (한림대학교 의과대학 내과학교실, 신장연구소) ;
  • 이승민 (한림대학교 의과대학 내과학교실, 신장연구소) ;
  • 이동훈 (한림대학교 의과대학 내과학교실, 신장연구소) ;
  • 노정우 (한림대학교 의과대학 내과학교실, 신장연구소)
  • Published : 2012.03.01
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Abstract

A 59-year-old woman was admitted to our hospital with polydipsia and general weakness. She had a 30-year history of bipolar disorder and was being treated with risperidone (4 mg/day) and lithium carbonate (1,200 mg/day). During her time in hospital, her urine output and serum osmolality increased, and her urine osmolality decreased. She was found to have myoglobulinuria, an elevated creatine kinase level, and abnormal renal function. Based on these findings, the patient was diagnosed with diabetes insipidus and rhabdomyolysis secondary to lithium therapy. After fluid therapy and the withdrawal of lithium, her clinical symptoms improved significantly. Her urine volume decreased gradually after treatment with amiloride. The effects of lithium on the muscle system are unknown. Hyperosmolarity caused by lithium-induced diabetes insipidus is considered a contributing factor in rhabdomyolysis.

저자들은 조울증으로 6년간 리튬 치료를 받던 중 신성 요붕증과 횡문근융해증이 발생한 환자에서 수액 치료와 리튬 중단과 thiazide, amiloride 투여로 호전된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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