Lithium Carbonate

Ronald E. Domen, MD; Roy E. Smith, MD; Arthur L. Sagone, MD
Arch Intern Med. 1981;141(2):268. doi:10.1001/archinte.1981.00340020130036.
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To the Editor.  —Lithium carbonate has been advocated for the treatment of aplastic anemia1,2 and chemotherapyinduced neutropenia.3 Recently, lithium treatment has also been associated with the induction of bone marrow panhypoplasia.4 We report here a case of pure RBC aplasia associated with lithium treatment.

Report of a Case.  —In September 1979, a 53-year-old woman suffering from a manic-depressive disorder was admitted to the Ohio State University Hospital, Columbus, after a two-day history of coma and intermittent generalized seizures. Treated with 900 mg/day of lithium carbonate since 1973, family members related that she had recently increased her intake severalfold in the week before admission. Initial laboratory studies showed a hemoglobin value of 16.7 g/dL; hematocrit reading, 50.8%; WBC count, 17,000/cu mm; platelet count, 297,000/cu mm; BUN level, 84 μg/ dL; serum creatinine level, 4.2 μg/dL; serum osmolality, 331 mOsm/kg; and urinary sodium level, 5 mEq/L. Findings from a


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