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 accessOne-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:
Subscribe to SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Effects of lithium carbonate on human calcium metabolism.Arch Intern Med. 1986; 146: 770-776
- Lithium increases tritiated thymidine uptake by abnormal human parathyroid tissue.Surgery. 1991; 110: 1067-1077
- Lithium induces abnormal calcium-regulated PTH release in dispersed bovine parathyroid cells.J Clin Endocrinol Metab. 1981; 52: 1046-1048
- Lithium stimulates the release of human parathyroid hormone in vitro.J Clin Endocrinol Metab. 1988; 66: 1187-1191
- 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
- Lithium treatment increases intact and midregion parathyroid hormone and parathyroid volume.J Clin Endocrinol Metab. 1989; 68: 654-660
- Hyperparathyroidism detected by routine serum calcium analysis: prevalence in a clinic population.Ann Intern Med. 1965; 63: 468-474
- A plethora of primary hyperparathyroidism.Arch Surg. 1971; 103: 12-13
- Set-point for parathyroid hormone release increases with postmaturational aging in the rat.Endocrinology. 1992; 131: 2251-2256
Article info
Publication history
Accepted:
November 10,
1994
Identification
Copyright
© 1995 Mosby-Year Book, Inc. Published by Elsevier Inc.
