Lithium carbonate-induced giant goiter and subclinical hyperthyroidism in a patient with schizophrenia:A case report and review of literature  

作　　者：Xing-Ming Chen Zhi-Li Jiang Xiang Wu Xu-Guang Li 

机构地区：[1]Department of Psychiatry,The Affiliated Brain Hospital of Guangzhou Medical University,Guangzhou 510370,Guangdong Province,China [2]Department of General Surgery,The Affiliated Brain Hospital of Guangzhou Medical University,Guangzhou 510370,Guangdong Province,China [3]Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province,The Ministry of Education of China,Guangzhou Medical University,Guangzhou 511436,Guangdong Province,China

出　　处：《World Journal of Clinical Cases》2024年第20期4357-4364,共8页世界临床病例杂志

摘　　要：BACKGROUND Lithium carbonate is used to manage various mood disorders,but it can cause thyroid abnormalities,including goiter,hypothyroidism,and hyperthyroidism.In rare cases,it can lead to giant goiter and subclinical hyperthyroidism,which may require surgical intervention in severe cases.CASE SUMMARY This case represents a rare development of giant goiter and subclinical hyperthyroidism in a schizophrenia patient who was subjected to prolonged lithium carbonate treatment.The enlarged thyroid gland caused pressure on the airway and recurrent laryngeal nerve,which led to respiratory distress,hoarseness,and dysphagia.The immediate danger of suffocation required urgent surgical intervention.In this report,we describe the case of a 41-year-old Chinese woman.This sheds light on the etiology and challenges associated with managing a giant goiter.The patient underwent a subtotal thyroidectomy to relieve airway compression and facilitate airway expansion.Prior to the procedure,the patient was given iodine to prepare.Concurrently,changes were made to the psychiatric medication regimen.Following surgery,the patient's respiratory function and vocal cord functionality improved significantly,and her mental state remained stable.CONCLUSION It is essential to monitor thyroid function,test thyroid antibody levels,and perform thyroid ultrasounds consistently in all patients undergoing long-term lithium carbonate treatment.This vigilance helps prevent severe and potentially life-threatening thyroid enlargement.

关 键 词：Lithium carbonate Giant goiter Subclinical hyperthyroidism SCHIZOPHRENIA Subtotal thyroidectomy Case report 

分 类 号：R735.4[医药卫生—肿瘤]