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The prevalence of lithium-associated hyperparathyroidism in a large Swedish population attending psychiatric outpatient units
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Geriatrics.ORCID iD: 0000-0002-5162-0328
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Psychiatry.ORCID iD: 0000-0001-6726-7787
Department of Psychiatry, Ryhov Hospital, Sweden .
Department of Surgery, Ryhov Hospital, Jonkoping, Sweden .
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2015 (English)In: Journal of Clinical Psychopharmacology, ISSN 0271-0749, E-ISSN 1533-712X, Vol. 35, no 3, 279-285 p.Article in journal (Refereed) Published
Abstract [en]

Objective: This retrospective study determined the prevalence of lithium-associated hyperparathyroidism (LHPT) in 2 geographically defined, equivalent populations in Sweden, with no other selection bias.

Methods: The medical journals of all patients receiving lithium treatment were examined specifically regarding their biochemistry: calcium, parathyroid hormone (PTH), creatinine, and vitamin D. The condition LHPT was defined biochemically. All patient data were noted, and the prevalence of the condition could thereby be calculated.

Results: A total of 423 patients were included (251 women and 172 men; 3: 2), treated over a mean of 13.5 years (range, 1-46 years), aged 19 to 92. 77 patients (18%) were identified with LHTP whose median serum calcium-was 2.55 mmol/L and PTH was 99 ng/L. A further 21% showed tendencies toward hypercalcemia. Forty-three percent had vitamin D insufficiency. Five patients (approximately 1%) had undergone parathyroidectomy.

Conclusion: The prevalence of LHPT is high and often goes undetected. Vitamin D insufficiency is common as is polypharmacy. Surgery, for unclear reasons, has not been performed extensively, possibly because of limited knowledge of the underlying pathophysiology or surgery's significance. We present standard recommendations on patient management and suggest continual, specific follow-up including the monitoring of calcium, PTH, and vitamin D at least annually. Surgery should be considered with intention to improve psychiatric well-being and provide multiorgan protection.

Place, publisher, year, edition, pages
2015. Vol. 35, no 3, 279-285 p.
Keyword [en]
hypercalcemia; hyperparathyroidism; Lithium; prevalence
National Category
Pharmacology and Toxicology Psychiatry
Research subject
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-44863DOI: 10.1097/JCP.0000000000000303ISI: 000353817400011PubMedID: 25853371Scopus ID: 2-s2.0-84929161233OAI: oai:DiVA.org:oru-44863DiVA: diva2:818844
Available from: 2015-06-09 Created: 2015-06-09 Last updated: 2017-03-17Bibliographically approved

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Meehan, Adrian D.Humble, Mats B.Wallin, Göran
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