A case of acute lithium poisoning and hypermagnesemia involving advanced colon cancer-induced colonic obstruction.

IF 0.5 Q3 MEDICINE, GENERAL & INTERNAL

Oxford Medical Case Reports Pub Date : 2024-09-12 eCollection Date: 2024-09-01 DOI:10.1093/omcr/omae107

Hideo Takayama, Takuya Komura, Taro Kawane, Toshiki Matsuo, Makiko Kimura, Masashi Nishikawa, Kiyoki Kitagawa, Wataru Omi, Kenichi Sakajiri, Ichiro Onishi, Satoru Sakagami, Taro Yamashita, Takashi Kagaya

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Abstract

An 83-year-old woman presented with disturbance of consciousness and hand tremor. She had taken lithium carbonate 300 mg/day for bipolar disorder and magnesium oxide 660 mg/day for constipation. Blood tests revealed lithium poisoning, hypermagnesemia and acute kidney injury. Computed tomography showed colonic obstruction caused by cancer of the descending colon. In the outpatient section, her blood pressure decreased to 89/54 mmHg, and her heart rate dropped to 40 bpm. We considered that the obstructive ileus induced intravascular dehydration, which led to toxic serum concentrations of lithium and magnesium, triggering the emergence of severe arrythmia induced by sinus dysfunction. The patient was treated with fluid resuscitation and hemodialysis, followed by endoscopic stent replacement for the descending colon cancer obstruction. These treatments improved her general condition and alleviated the lithium poisoning, hypermagnesemia and colonic obstruction. Such a case is considered extremely rare.

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一例急性锂中毒和高镁血症病例，涉及晚期结肠癌引发的结肠阻塞。

一名 83 岁的妇女因意识障碍和手颤抖前来就诊。她曾服用碳酸锂 300 毫克/天治疗双相情感障碍，服用氧化镁 660 毫克/天治疗便秘。血液检查显示她锂中毒、高镁血症和急性肾损伤。计算机断层扫描显示，降结肠癌导致结肠阻塞。在门诊部，她的血压降至 89/54 mmHg，心率降至 40 bpm。我们认为，梗阻性回肠引起了血管内脱水，导致血清中锂和镁浓度中毒，引发了由窦性功能障碍引起的严重心律失常。患者接受了液体复苏和血液透析治疗，随后接受了内窥镜支架置换术治疗降结肠癌梗阻。这些治疗改善了她的一般状况，缓解了锂中毒、高镁血症和结肠阻塞。这样的病例极为罕见。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oxford Medical Case Reports MEDICINE, GENERAL & INTERNAL-

CiteScore

0.90

自引率

0.00%

发文量

125

审稿时长

19 weeks

期刊介绍： Oxford Medical Case Reports (OMCR) is an open access, peer-reviewed online journal publishing original and educationally valuable case reports that expand the field of medicine. The journal covers all medical specialities including cardiology, rheumatology, nephrology, oncology, neurology, and reproduction, comprising a comprehensive resource for physicians in all fields and at all stages of training. Oxford Medical Case Reports deposits all articles in PubMed Central (PMC). Physicians and researchers can find your work through PubMed , helping you reach the widest possible audience. The journal is also indexed in the Web of Science Core Collection . Oxford Medical Case Reports publishes case reports under the following categories: Allergy Audiovestibular medicine Cardiology and cardiovascular systems Critical care medicine Dermatology Emergency medicine Endocrinology and metabolism Gastroenterology and hepatology Geriatrics and gerontology Haematology Immunology Infectious diseases and tropical medicine Medical disorders in pregnancy Medical ophthalmology Nephrology Neurology Oncology Paediatrics Pain Palliative medicine Pharmacology and pharmacy Psychiatry Radiology, nuclear medicine, and medical imaging Respiratory disorders Rheumatology Sexual and reproductive health Sports Medicine Substance abuse.