IS case 499: Lithium nephrotoxicity
Imaging Sciences URMC 2010
Publication Date: 2010-08-30
Lithium is the medication of choice for bipolar mood stabilization in the US. Most cases of lithium nephrotoxicity occur within a month of beginning therapy and manifests as polyuria and polydipsia. Initially these symptoms are reversible, but long-term use or high serum levels can cause permanent renal insufficiency. T2WI images usually show innumerable tiny (2-5 mm) cysts throughout the kidney.
The differential consideration for multiple renal cysts should include autosomal dominant polycystic kidney disease (ADPKD) (which usually presents as larger cysts), autosomal recessive polycystic kidney disease (ARPKD) (which occurs in children), tuberous sclerosis (the cysts can be larger, and this is associated with angiomyolipomas), medullary cystic kidney disease and glomerulocystic kidney disease.
- Farres MT, Ronco P, Saadoun D, et al. Chronic lithium nephropathy: MR imaging for diagnosis. Radiology. 2003 Nov;229(2):570-4. PMID: 14595154