The review of hematologic and other biochemical parameters in lithium monotherapy patients

Year 2012, , 109 - 114, 01.03.2012

Tevfik Kalelioğlu Akif Taşdemir Abdullah Genç Esra Sena Genç İsmail Özver Dilek Yeşilbaş Kürşat Altınbaş Erhan Kurt

https://doi.org/10.5455/jmood.20120711044126

Abstract

Aims: Long term treatment with lithium has been suggested to cause prominent toxic effects on different organs and systems. We aimed to investigate the effect of lithium on liver, kidney, and thyroid functions and hematopoietic system in euthymic patients with bipolar mood disorder, who have been on lithium monotherapy. Methods: The medical charts of the bipolar patients from January 2009 to January 2011 were screened. Liver, kidney, and thyroid function test results and complete blood count parameters were recorded. The data of patients, who were under lithium monotherapy for three months or longer, were included in the study. Results: A total of sixty five patients were included in this study and 41.5% of the patients (n=27) were male and 58.5% (n=38) were female. All patients were diagnosed with Type I Bipolar Disorder. The mean age of the patients was 40.47±11.41; 41.84±12.49 years for females versus 38.88±9.61 years for males (p=0.313). The mean duration of illness was 16.70±9.86 years and the received mean lithium dose was 1160±274 mg/day. The duration of lithium therapy was 156.29±117.53 weeks (min: 12 max: 410); 139.26±130.20 weeks in males and 168.39±107.80 weeks in females (p=0.207). There were significant differences between genders for creatinine, uric acid, and creatinine levels (p<0.001, p<0.001, and p=0.034, respectively) and for hemoglobin, hematocrit, and MPV values (p<0.001, p<0.001, p=0.019, respectively). Hematocrit values of the 13,8% of women were below the reference range, however hematocrit values of male patients were between reference range (?2=7.422, p=0.006). There were higher neutrophil levels in 47.7% of patients, thrombocytopenia in the 4.6% of patients, and thrombocytosis in the 4.6% of patients. There were no significant differences between gender according to average values of fT3 (p=0.173), fT4 (p=0.167), and TSH (p=0.170). Conclusion: Kidney and liver functions in patients with bipolar mood disorder, who have been on long term lithium monotherapy generally seemed to be in reference range, however some differences were observed in some patients. The side effects of lithium monotherapy on the different organs or systems were similar to reported findings in the literature.

Keywords

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Lityum Tekli Tedavisi Alan Hastaların Hematolojik ve Biyokimyasal Değerlerinin İncelenmesi

Abstract

Amaç: Tedavi edici dozlarda uzun dönem lityum (Li)
tedavisinin değişik organ ve sistemler üzerinde belirgin
toksik etkiler oluşturabileceği üzerinde durulmaktadır.
Lityum tekli tedavisi altındaki ötimik iki uçlu bozukluk
hastalarında lityumun karaciğer, böbrek, tiroid işlevleri ve
hematopoetik sisteme etkisinin geriye dönük araştırılması
amaçlanmıştır.
Yöntem: Hastaların Ocak 2009’dan Ocak 2011 tarihine
kadarki tıbbi dosya verileri tarandı. Karaciğer, böbrek,
tiroid fonksiyon testleri sonuçları ve tam kan sayımına ait
bilgiler kaydedildi. En az üç aydır lityum tekli tedavisi kullanan
hasta dosyalarının verileri çalışmaya alındı.
Bulgular: 65 hasta çalışmaya dahil edildi. Hastaların
%41.5’i (n=27) erkek, %58.5’i (n=38) kadın ve bütün hastalar
İki uçlu Bozukluk Tip I idi. Hastaların yaş ortalaması
40.47±11.41 idi. Hastaların hastalık süreleri 16.70±9.86 yıl
ve kullandığı ortalama lityum dozu 1160±274 mg/gün ve
kullanma süresi 156.29±117.53 hafta (min: 12, max: 410).
Kreatinin, ürik asit ve albümin değerlerinde (sırasıyla;
p < 0.001, p < 0.001 ve p=0.034) ve hemoglobin, hematokrit
ve MPV değerlerinde cinsiyetler arasında anlamlı fark mevcuttu
(sırasıyla; p < 0.001, p < 0.001, p=0.019). Hastaların
%47.7’sinde nötrofil yüksekliği, %4.6’sında trombositopeni
ve %4.6’sında trombositozis saptandı. Kadın ve erkekler
arasında ortalama sT3 (p=0.173), sT4 (p=0.167) ve TSH
(p=0.170) açısından istatistiksel olarak anlamlı bir fark
bulunmadı.
Sonuç: Uzun dönem lityum tekli tedavisi alan iki uçlu
bozukluk hastalarında ortalama böbrek ve karaciğer işlevlerinin
genel olarak normal sınırlarda seyrettiği ancak bazı
kişilerde farklılıklar olabileceği gözlenmiştir. Lityum tekli
tedavisinin farklı organ ve sistemler üzerindeki yan etkileri
literatür bilgileriyle uyumluydu.

Keywords

lityum tekli tedavi, metabolik parametreler, tiroid, hematolojik sistem

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