| Title |
Cutaneous adverse reaction during lithium treatment: a case report and updated systematic review with meta-analysis
|
|---|---|
| Published in |
International Journal of Bipolar Disorders, July 2017
|
| DOI | 10.1186/s40345-017-0091-7 |
| Pubmed ID | |
| Authors |
Martina Pinna, Mirko Manchia, Sergio Puddu, Giampaolo Minnai, Leonardo Tondo, Piergiorgio Salis |
| Abstract |
To present a new case of adverse cutaneous reaction during lithium treatment and to update the systematic review and meta-analysis of the incidence of this adverse reaction. We conducted a systematic search (performed in September 2016) for peer-reviewed articles in English indexed in Medline (2011-present). Meta-analytical estimates were obtained using the "Metafor" package. Ms. H., a 31-year-old Caucasian woman with BD1, was admitted to the inpatient unit for a full-blown psychotic episode and treated with carbamazepine 400 mg q.d., lithium carbonate 450 mg q.d., and risperidone 4 mg q.d. with clinical improvement. After 12 days from the start of psychopharmacological treatment, she manifested a cutaneous reaction that motivated the stop of carbamazepine treatment, as well as the increase in lithium carbonate dose (750 mg q.d.). Risperidone dose remained unvaried. Since the skin lesion persisted after 8 days from withdrawal of carbamazepine, the private practitioner stopped also lithium carbonate treatment (de-challenge), maintaining risperidone treatment. The cutaneous reaction resolved spontaneously after six days from withdrawal of lithium carbonate. Subsequently, the worsening of psychopathological conditions motivated a new admission during which lithium carbonate was reintroduced (16 days after its suspension) (re-challenge). On the following day, we observed an itching erythematous maculopapular rash involving the trunk, the four limbs, and the oral mucosa. Our case of an erythematous maculopapular rash during lithium treatment was the first to present a challenge-de-challenge-re-challenge sequence that suggests causality. Although meta-analysis does not point to an increased rate of adverse skin reaction during lithium treatment, clinicians should not neglect to monitor cutaneous symptoms during lithium treatment. |
Mendeley readers
The data shown below were compiled from readership statistics for 36 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 36 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 6 | 17% |
| Student > Master | 4 | 11% |
| Researcher | 3 | 8% |
| Professor > Associate Professor | 3 | 8% |
| Librarian | 2 | 6% |
| Other | 7 | 19% |
| Unknown | 11 | 31% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 8 | 22% |
| Pharmacology, Toxicology and Pharmaceutical Science | 5 | 14% |
| Nursing and Health Professions | 3 | 8% |
| Psychology | 3 | 8% |
| Engineering | 2 | 6% |
| Other | 3 | 8% |
| Unknown | 12 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 July 2017.
All research outputs
#20,431,953
of 22,985,065 outputs
Outputs from International Journal of Bipolar Disorders
#260
of 286 outputs
Outputs of similar age
#273,455
of 313,616 outputs
Outputs of similar age from International Journal of Bipolar Disorders
#11
of 12 outputs
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