# Lithium-Induced Hyperparathyroidism in a Patient With Bipolar Disorder: The Importance of Monitoring Complications in Patients Undergoing Chronic Lithium Therapy

## TL;DR

A patient with bipolar disorder developed hyperparathyroidism and kidney issues from long-term lithium use, highlighting the need for regular monitoring.

## Contribution

This case emphasizes the importance of monitoring parathyroid and kidney function in patients on chronic lithium therapy.

## Key findings

- The patient developed hypercalcemia, elevated PTH, and CKD after long-term lithium therapy.
- Discontinuation of lithium led to improvement in the patient's condition.
- Routine monitoring can help detect and mitigate complications early.

## Abstract

Lithium remains a cornerstone in the pharmacological management of bipolar disorder due to its well-established mood-stabilizing properties. However, chronic lithium therapy is associated with a spectrum of potential complications, including hyperparathyroidism and progression to chronic kidney disease (CKD). We present the case of a patient with bipolar disorder who developed lithium-induced hyperparathyroidism and CKD following long-term lithium therapy. During a routine follow-up, the patient was found to have hypercalcemia, elevated parathyroid hormone levels, and increased serum creatinine. A comprehensive diagnostic workup confirmed the diagnosis of lithium-induced hyperparathyroidism and CKD. Notably, the patient's condition improved following the discontinuation of lithium therapy. This report details the patient's clinical course, diagnostic evaluation, and management strategies, underscoring the importance of routine monitoring of parathyroid function (serum calcium, PTH levels) and renal function (serum creatinine, electrolytes, and urinalysis) in patients undergoing long-term lithium treatment. Early detection and intervention are critical to mitigating the risk of these complications and optimizing patient outcomes.