背景:这项研究的目的是评估锂治疗对白细胞(WBC)计数的长期影响,血清肌酐,在土耳其儿童和青少年样本中,患有双相情感障碍(BD)和非BD的儿童和青少年的促甲状腺激素(TSH)水平。方法:本研究基于回顾性图表回顾。该研究包括2012年至2017年间在精神健康和神经系统疾病医院接受BD和非BD处方锂的儿童和青少年患者。数据是从电子医疗文件中收集的。白细胞计数的实验室值,血清肌酐,在锂发病前一周内的基线TSH水平,在1号,3rd,6th,记录治疗12个月.结果:共143例患者(82例女性,61男性;100BD,包括43名9-18岁的非BD)。非BD诊断为精神病和分裂情感障碍,单相抑郁症,注意力缺陷/多动障碍,行为障碍,严重的情绪失调综合征,边缘性人格障碍,和自闭症。双极组参与者的平均年龄为15.90±1.16岁,非双极组参与者的平均年龄为14.88±1.79岁。BD患者报告了更多的不良反应。在任何时间点,WBC计数和TSH水平均有统计学上的显着增加。在治疗的第3个月和第12个月发现血清肌酐有统计学意义的升高。在锂治疗过程中,14例(9.8%)患者的白细胞计数超过13,000,41例(28.6%)患者的TSH水平超过5.5mU/L。21例(14.68%)患者开始接受甲状腺素替代治疗。TSH水平超过5.5mU/L的参与者的基础TSH水平和锂治疗持续时间较高。锂的最大剂量,锂血水平,基础TSH水平,接受甲状腺素替代治疗的参与者的治疗持续时间较高.没有患者的血清肌酐水平超过正常参考值。结论:我们的研究表明,对于患有BD和非BD的儿童和青少年,锂是一种通常安全且可耐受的药物;然而,密切监测甲状腺功能,特别是基础TSH水平较高且锂使用时间较长的患者,非常重要.
Background: The aim of this
study was to evaluate the long-term effects of lithium treatment on white blood cell (WBC) count, serum creatinine, and thyroid-stimulating hormone (TSH) levels in children and adolescents with bipolar disorder (BD) and non-BD in a Turkish children and adolescent sample. Methods: The
study is based on retrospective chart review. Children and adolescent patients with BD and non-BD prescribed lithium in a mental health and neurological disorders hospital between 2012 and 2017 were included in the
study. Data were collected from the electronic medical files. Laboratory values for WBC count, serum creatinine, and TSH levels at baseline within the week before the onset of lithium, and at 1st, 3rd, 6th, and 12th month of treatment were recorded. Results: A total of 143 patients (82 females, 61 males; 100 BD, 43 non-BD) aged 9-18 were included. Non-BD diagnoses were psychotic and schizoaffective disorders, unipolar depression, attention-deficit/hyperactivity disorder, conduct disorder, severe mood dysregulation syndrome, borderline personality disorder, and autism. Mean age of the participants were 15.90 ± 1.16 years for the bipolar group and 14.88 ± 1.79 years for the nonbipolar group. Patients with BD reported more adverse effects. There was a statistically significant increase in WBC counts and TSH levels at any time point. A statistically significant elevation in serum creatinine was found at 3rd and 12th month of treatment. During the course of lithium treatment, WBC counts exceeded 13,000 in 14 (9.8%) patients, and TSH levels exceeded 5.5 mU/L in 41 patients (28.6%). Twenty-one (14.68%) patients were started on thyroxin replacement. Basal TSH levels and duration of the lithium treatment were higher in the participants with TSH levels exceeding 5.5 mU/L. Lithium maximum dose, lithium blood level, basal TSH level, and duration of treatment were higher in the participants receiving thyroxin replacement. No patients had serum creatinine levels exceeding the normal reference values. Conclusion: Our
study suggests that lithium is a generally safe and tolerable agent for children and adolescents with BD and non-BD; however, close monitoring of thyroid functions particularly in patients with a higher basal TSH level and longer duration of lithium use is important.