A Case Report of Lithium Overdose Patient with Low Anion Gap Metabolic Acidosis

鋰藥物過量中毒併低陰離子間隙差之代謝性酸中毒患個案報告

10.30035/TCCM.201003.0011

郭姵邑(Pei-I Kuo)；杜美玉(Tu May Yu)；林恒毅(Hen-I Lin)；馬漢光(Hon-Kwong Ma)

代謝性酸中毒 ； 鋰藥物過量中毒 ； 低陰離子間隙差 ； 高滲透壓間隙代謝性酸中毒 ； 意識不清之患者 ； Metabolic acidosis ； Lithium overdose ； Low anion gap metabolic acidosis ； Elevated osmolar gap metabolic acidosis ； Unconscious patient

重症醫學雜誌

11卷1期（2010 / 03 / 01）

68 - 72

英文

臨床上的重症患者常併發代謝性酸中毒。治療的方式主要依病因來做決定。病史是找出病因不可缺的重要因子。但通常到急診的病人及家屬都無法提供完整的病史。因此更進一步的檢查如詳細的體檢和抽血檢驗就更顯得相對重要。造成代謝性酸中毒的原因有很多，但鋰藥物過量中毒雖不少但卻常被忽略。鋰藥物過量中毒的治療依血清濃度和病人狀況而決定。

Metabolic acidosis is commonly seen in the clinical setting especially in the critical cases. The choice of the treatment depends on the underlying causes of metabolic acidosis. Medical history is an essential key for determining the underlying cause of the disease. However the medical history provided by the patient or the family members is usually not complete when the patient arrived at the Emergency department. Therefore, further investigations such as physical examination and the laboratory tests are critical. Among all underlying causes of metabolic acidosis, Lithium overdose induced metabolic acidosis is not uncommon but diagnosis is often missed due to incomplete history of medication. Lithium intoxication could be treated by hemodialysis or hydration effectively depending on the serum lithium level and hemodynamic stability.