Lithium Toxicity Associated with Pancytopenia And Megaloblastic Anaemia.

ABSTRACT

A 29-year-old male was treated for Bipolar Affective Disorder since 5 months with Lithium 400 mg per day which was gradually up titrated to 800 mg in 10 days of start of treatment in view of minimal improvement in symptoms. After 2 months of treatment patient started experiencing weakness and fatiguability. During third month of treatment patent had complaints of 3 episodes of vomiting associated with nausea, mild abdominal pain, diarrhea, dyspnea on exertion, restlessness, tremors, dry mouth and decreased sleep. Patient was brought to emergency department and all baseline investigations were done which were suggestive of Pancytopenia. Hematology reference was done, and lithium toxicity was considered as contributing factor for above symptoms and results. Short-term lithium administration may be life-threatening and should thus be prescribed cautiously in hematological disorders as in other conditions