Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2020

Open Access 01-12-2020 | Tremor | Case report

Lithium intoxication–induced dysgeusia accompanied by glossalgia in a patient receiving lithium carbonate: a case report

Authors: Shota Hanyu, Naoko Sugita, Miyuki Matsuda, Toshiya Murai, Hironobu Fujiwara

Published in: Journal of Medical Case Reports | Issue 1/2020

Login to get access

Abstract

Background

Lithium carbonate is widely used as a first-line therapeutic agent for the depressive and manic phases of bipolar disorder. Although limb tremors and hypothyroidism are well-known side effects of lithium carbonate, other rare adverse reactions can also occur.

Case presentation

A 53-year-old Japanese woman diagnosed with lithium intoxication developed dysgeusia and glossalgia during treatment with lithium carbonate. She also showed symptoms of a swaying gait, finger tremors, and dysarthria. All of these symptoms subsided when her blood lithium concentration was reduced to a level below that which induces intoxication.

Conclusions

We present a rare case of lithium carbonate–induced dysgeusia accompanied by glossalgia. Early detection of these symptoms is important in clinical settings because they can be overlooked until patients lose their appetite, which severely impairs their quality of life.
Literature
1.
go back to reference McKnight RF, Adida M, Budge K, Stockton S, Goodwin GM, Geddes JR. Lithium toxicity profile: a systematic review and meta-analysis. Lancet. 2012;379:721–49.CrossRef McKnight RF, Adida M, Budge K, Stockton S, Goodwin GM, Geddes JR. Lithium toxicity profile: a systematic review and meta-analysis. Lancet. 2012;379:721–49.CrossRef
2.
go back to reference Nolen WA, Weisler RH. The association of the effect of lithium in the maintenance treatment of bipolar disorder with lithium plasma levels: a post hoc analysis of a double-blind study comparing switching to lithium or placebo in patients who responded to quetiapine (Trial 144). Bipolar Disord. 2013;15:100–9.CrossRef Nolen WA, Weisler RH. The association of the effect of lithium in the maintenance treatment of bipolar disorder with lithium plasma levels: a post hoc analysis of a double-blind study comparing switching to lithium or placebo in patients who responded to quetiapine (Trial 144). Bipolar Disord. 2013;15:100–9.CrossRef
3.
go back to reference Ott M, Stegmayr B, Salander RE, Werneke U. Lithium intoxication: incidence, clinical course and renal function – a population-based retrospective cohort study. J Psychopharmacol. 2016;30:1008–19.CrossRef Ott M, Stegmayr B, Salander RE, Werneke U. Lithium intoxication: incidence, clinical course and renal function – a population-based retrospective cohort study. J Psychopharmacol. 2016;30:1008–19.CrossRef
4.
go back to reference Haussmann R, Bauer M, von Bonin S, Grof P, Lewitzka U. Treatment of lithium intoxication: facing the need for evidence. Int J Bipolar Disord. 2015;3:23.CrossRef Haussmann R, Bauer M, von Bonin S, Grof P, Lewitzka U. Treatment of lithium intoxication: facing the need for evidence. Int J Bipolar Disord. 2015;3:23.CrossRef
5.
go back to reference Yukihiro M, Hideyuki T, Koichi K, Fumihiro M, Katumi M, Keiko A, et al. Clinical statistics of patients with lingual abnormalities including glossalgia – clinical characteristics of glossodynia [in Japanese]. Jpn J Orofac Pain. 2012;5:27–35. Yukihiro M, Hideyuki T, Koichi K, Fumihiro M, Katumi M, Keiko A, et al. Clinical statistics of patients with lingual abnormalities including glossalgia – clinical characteristics of glossodynia [in Japanese]. Jpn J Orofac Pain. 2012;5:27–35.
6.
go back to reference Yugo K, Yoshiyuki O, Shinnosuke I, Kensuke K, Yoshimi I. Clinical study of vitamin B12 therapy to Hunter glossitis. Oral Ther Pharmacol. 2015;34:1–8. Yugo K, Yoshiyuki O, Shinnosuke I, Kensuke K, Yoshimi I. Clinical study of vitamin B12 therapy to Hunter glossitis. Oral Ther Pharmacol. 2015;34:1–8.
7.
go back to reference Tighe P, Ward M, McNulty H, Finnegan O, Dunne A, Strain J, et al. A dose-finding trial of the effect of long-term folic acid intervention: implications for food fortification policy. Am J Clin Nutr. 2011;93:11–8.CrossRef Tighe P, Ward M, McNulty H, Finnegan O, Dunne A, Strain J, et al. A dose-finding trial of the effect of long-term folic acid intervention: implications for food fortification policy. Am J Clin Nutr. 2011;93:11–8.CrossRef
8.
go back to reference Goel A, Bakshi SS, Soni N, Chhavi N. Iron deficiency anemia and Plummer-Vinson syndrome: current insights. J Blood Med. 2017;8:175–84.CrossRef Goel A, Bakshi SS, Soni N, Chhavi N. Iron deficiency anemia and Plummer-Vinson syndrome: current insights. J Blood Med. 2017;8:175–84.CrossRef
9.
go back to reference Short MW, Domagalski JE. Iron deficiency anemia: evaluation and management. Am Fam Physician. 2013;87:98–104.PubMed Short MW, Domagalski JE. Iron deficiency anemia: evaluation and management. Am Fam Physician. 2013;87:98–104.PubMed
10.
go back to reference Akiko S, Tomomi N, Hideki O, Emi M, Atsushi N, Masanori U, et al. Clinical analysis of 1059 patients with taste disorders [in Japanese]. Nippon Jibiinkoka Gakkai Kaiho. 2013;116:77–82.CrossRef Akiko S, Tomomi N, Hideki O, Emi M, Atsushi N, Masanori U, et al. Clinical analysis of 1059 patients with taste disorders [in Japanese]. Nippon Jibiinkoka Gakkai Kaiho. 2013;116:77–82.CrossRef
11.
go back to reference Masafumi S, Yuichi K, Akira I, Noriaki T, Tsunemasa A, Tomomi N, et al. Time course of changes in gustatory function test results and subjective symptoms, and predictive factors for response in patients with taste disorder receiving 24-week zinc replacement treatment [in Japanese]. Nippon Jibiinkoka Gakkai Kaiho. 2014;117:1093–101.CrossRef Masafumi S, Yuichi K, Akira I, Noriaki T, Tsunemasa A, Tomomi N, et al. Time course of changes in gustatory function test results and subjective symptoms, and predictive factors for response in patients with taste disorder receiving 24-week zinc replacement treatment [in Japanese]. Nippon Jibiinkoka Gakkai Kaiho. 2014;117:1093–101.CrossRef
12.
go back to reference Rej S, Herrmann N, Shulman K. The effects of lithium on renal function in older adults – a systematic review. J Geriatr Psychiatry Neurol. 2012;25:51–61.CrossRef Rej S, Herrmann N, Shulman K. The effects of lithium on renal function in older adults – a systematic review. J Geriatr Psychiatry Neurol. 2012;25:51–61.CrossRef
13.
go back to reference Timmer RT, Sands JM. Lithium intoxication. J Am Soc Nephrol. 1999;10:666–74.PubMed Timmer RT, Sands JM. Lithium intoxication. J Am Soc Nephrol. 1999;10:666–74.PubMed
14.
go back to reference Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013. Bipolar Disord. 2013;15:1–44.CrossRef Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013. Bipolar Disord. 2013;15:1–44.CrossRef
15.
go back to reference Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Möller HJ, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2012 on the long-term treatment of bipolar disorder. World J Biol Psychiatry. 2013;14:154–219.CrossRef Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Möller HJ, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2012 on the long-term treatment of bipolar disorder. World J Biol Psychiatry. 2013;14:154–219.CrossRef
16.
go back to reference National Institute for Health and Care Excellence (NICE). Bipolar disorder: assessment and management. NICE Clinical Guideline 185. London: NICE [last updated 11 Feb 2020]. National Institute for Health and Care Excellence (NICE). Bipolar disorder: assessment and management. NICE Clinical Guideline 185. London: NICE [last updated 11 Feb 2020].
17.
go back to reference Goodwin GM, Haddad PM, Ferrier IN, Aronson JK, Barnes T, Cipriani A, et al. Evidence-based guidelines for treating bipolar disorder: revised third edition recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2016;30:495–553.CrossRef Goodwin GM, Haddad PM, Ferrier IN, Aronson JK, Barnes T, Cipriani A, et al. Evidence-based guidelines for treating bipolar disorder: revised third edition recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2016;30:495–553.CrossRef
18.
go back to reference Ostacher MJ, Tandon R, Suppes T. Florida best practice psychotherapeutic medication guidelines for adults with bipolar disorder: a novel, practical, patient-centered guide for clinicians. J Clin Psychiatry. 2016;77:920–6.CrossRef Ostacher MJ, Tandon R, Suppes T. Florida best practice psychotherapeutic medication guidelines for adults with bipolar disorder: a novel, practical, patient-centered guide for clinicians. J Clin Psychiatry. 2016;77:920–6.CrossRef
19.
go back to reference Malhi GS, Gessler D, Outhred T. The use of lithium for the treatment of bipolar disorder: recommendations from clinical practice guidelines. J Affect Disord. 2017;217:266–80.CrossRef Malhi GS, Gessler D, Outhred T. The use of lithium for the treatment of bipolar disorder: recommendations from clinical practice guidelines. J Affect Disord. 2017;217:266–80.CrossRef
20.
go back to reference Meltzer H. Antipsychotic agents & lithium. In: Katzung BG, Masters SB, Trevor AJ, editors. Basic and clinical pharmacology. 11th ed. New York: McGraw-Hill Medical; 2009. p. 487. Meltzer H. Antipsychotic agents & lithium. In: Katzung BG, Masters SB, Trevor AJ, editors. Basic and clinical pharmacology. 11th ed. New York: McGraw-Hill Medical; 2009. p. 487.
21.
go back to reference Ilse F, Joost H. Long lasting impairment of taste and smell as side effect of lithium carbonate in a cluster headache patient. Headache. 2016;56:1201–3.CrossRef Ilse F, Joost H. Long lasting impairment of taste and smell as side effect of lithium carbonate in a cluster headache patient. Headache. 2016;56:1201–3.CrossRef
22.
23.
go back to reference Himmelhoch JM, Hanin I. Side effects of lithium carbonate [letter]. Br Med J. 1974;4:233.CrossRef Himmelhoch JM, Hanin I. Side effects of lithium carbonate [letter]. Br Med J. 1974;4:233.CrossRef
24.
go back to reference Bressler B. An unusual side-effect of lithium. Psychosomatics. 1980;21:688–9.CrossRef Bressler B. An unusual side-effect of lithium. Psychosomatics. 1980;21:688–9.CrossRef
25.
26.
go back to reference Takeshi T, Shosuke W, Nobuhiko H, Takayuki H. Strange taste and mild lithium intoxication. BMJ Case Rep. 2011;2011:bcr0520114267. Takeshi T, Shosuke W, Nobuhiko H, Takayuki H. Strange taste and mild lithium intoxication. BMJ Case Rep. 2011;2011:bcr0520114267.
27.
go back to reference Gracious BL, Llana M, Barton DD. Lithium and geographic tongue. J Am Acad Child Adolesc Psychiatry. 1999;38:1069–70.CrossRef Gracious BL, Llana M, Barton DD. Lithium and geographic tongue. J Am Acad Child Adolesc Psychiatry. 1999;38:1069–70.CrossRef
28.
go back to reference Selvakumar N, Selvapandian TJ, Menon V, Rajkumar RP. Black hairy tongue (Lingua villosa nigra) in a young male precipitated by lithium. Asian J Psychiatr. 2016;24:71–2.CrossRef Selvakumar N, Selvapandian TJ, Menon V, Rajkumar RP. Black hairy tongue (Lingua villosa nigra) in a young male precipitated by lithium. Asian J Psychiatr. 2016;24:71–2.CrossRef
29.
go back to reference Chen WY, Chen AC, Tsai SJ, Lin JJ. Reversible oro-lingual dyskinesia related to lithium intoxication. Acta Neurol Taiwanica. 2013;22:32–5. Chen WY, Chen AC, Tsai SJ, Lin JJ. Reversible oro-lingual dyskinesia related to lithium intoxication. Acta Neurol Taiwanica. 2013;22:32–5.
Metadata
Title
Lithium intoxication–induced dysgeusia accompanied by glossalgia in a patient receiving lithium carbonate: a case report
Authors
Shota Hanyu
Naoko Sugita
Miyuki Matsuda
Toshiya Murai
Hironobu Fujiwara
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2020
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-020-02495-6

Other articles of this Issue 1/2020

Journal of Medical Case Reports 1/2020 Go to the issue