Research Article| Volume 117, ISSUE 5, P577-580, May 1995

Download started.


Effects of long-term lithium infusion on normal parathyroid tissue

      This paper is only available as a PDF. To read, Please Download here.
      Background. Approximately 10% of patients taking lithium for manic-depressive disorders become hypercalcemic. It remains unclear whether lithium initiates disease or promotes underlying hyperparathyroidism. We have previously demonstrated that at therapeutic concentrations lithium stimulates in vitro incorporation of both tritiated thymidine and bromodeoxyuridine into abnormal human parathyroid tissue, reflecting growth-promoting properties. Whether lithium has similar growth-promoting properties in normal parathyroid tissue remains unresolved
      Methods. We infused lithium (0 mmol/L, 3 mmol/L, or 10 mmol/L) through implantable subcutaneous pumps into normal rats for 3 months and measured levels of serum lithium, serum calcium, and serum parathyroid hormone (PTH) (with a radioimmunoassay specific for rat PTH 1–34.) On completion of the infusion, bromodeoxyuridine (30 mg/kg) was administered intraperitoneally. The parathyroid glands were removed and measured in two dimensions to calculate gland volume [V=(π/6)×(d1)×(d2)2.] Parathyroid incorporation of bromodeoxyuridine was assessed by using immunocytochemistry.
      Results. Serum lithium level was significantly (p<0.05) different between groups and constant within groups. Levels of serum calcium and PTH were inversely related to each other; however, no significant differences were noted between groups with respect to level of serum calcium or serum PTH at any measurement. Similarly, no significant differences were noted between groups with respect to gland size or number of bromodeoxyuridine-positive cells.
      Conclusions. Long-term lithium infusion in rats for a period representing approximately 15% of their life span failed to evoke changes in parathyroid gland size or function. These data are consistent with (1) lithium as a promoter of hyperparathyroidism and (2) resection of abnormal parathyroid tissue and resumption of lithium for patients requiring long-term therapy.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Mallette LE
        • Eichhorn E
        Effects of lithium carbonate on human calcium metabolism.
        Arch Intern Med. 1986; 146: 770-776
        • Saxe AW
        • Gibson G
        Lithium increases tritiated thymidine uptake by abnormal human parathyroid tissue.
        Surgery. 1991; 110: 1067-1077
        • Brown EM
        Lithium induces abnormal calcium-regulated PTH release in dispersed bovine parathyroid cells.
        J Clin Endocrinol Metab. 1981; 52: 1046-1048
        • Birnbaum J
        • Klandorff H
        • Giuliano A
        • vanHerle A
        Lithium stimulates the release of human parathyroid hormone in vitro.
        J Clin Endocrinol Metab. 1988; 66: 1187-1191
        • Spiegel AM
        • Rudorfer MV
        • Marx SJ
        • Linnoila M
        The effect of short term lithium administration on suppressibility of parathyroid hormone secretion and calcium in vivo.
        J Clin Endocrinol Metab. 1984; 59: 354-357
        • Mallette LE
        • Khouri K
        • Zengotita H
        • Hollis BW
        • Malini S
        Lithium treatment increases intact and midregion parathyroid hormone and parathyroid volume.
        J Clin Endocrinol Metab. 1989; 68: 654-660
        • Boonstra CE
        • Jackson CE
        Hyperparathyroidism detected by routine serum calcium analysis: prevalence in a clinic population.
        Ann Intern Med. 1965; 63: 468-474
        • Preisman RA
        • Mehnert JH
        A plethora of primary hyperparathyroidism.
        Arch Surg. 1971; 103: 12-13
        • Uden P
        • Halloran B
        • Daly R
        • Duh QY
        • Clark O
        Set-point for parathyroid hormone release increases with postmaturational aging in the rat.
        Endocrinology. 1992; 131: 2251-2256