Author/Editor		Gaberšček, Simona; Kališnik, Miroslav; Hojker, Sergej
Title		Litij in ščitnica
Translated title		Lithium and thyroid
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 69, št. 7-8
Publication year		2000
Volume		str. 521-4
Language		slo
Abstract		Background. Lithium is widely used in treatment and prophylaxis of recidivant bipolar affective disorders. Lithium accumulates in thyroid gland and can cause: goiter in 8 - 50% of patients with normal thyroid gland befor lithium therapy (caused by interaction of lithium with iodide metabolism); disturbances of thyroid function in patients with positive antibodies against thyroid antigens befor lithium therapy, i.e., hypothyroidism in approximately 20% of patients and rarely hyperthyroidism. Influencing the immune system, lithium has an effect on incidence of autoimmune thyroid diseases. The risk for occurrence of thyroid function disturbances increases with the duration of lithium therapy. Conclusions. This article emphasises the importance of various effects of lithium therapy on thyroid gland. We recommend: 1.) estimation of thyroid morphology and function befor the introduction of lithium therapy, 2.) regular six-months controls of thyroid morphology and function during the lithium therapy; 3.) treatment of patients with goiter and patients with hypothyroidism by using L-thyroxin.
Summary		Izhodišča. Litij v obliki litijevega karbonata uporabljamo za zdravljenje in preprečevanje recidivov bipolarnih afektivnih motenj. Litij se koncentrira v ščitnici in lahko povzroči: golšo pri 8-50% bolnikov z normalno ščitnico pred terapijo z litijem (zaradi interakcije litija z metabolizmom jodida); motnje ščitnične funkcije pri bolnikih s pozitivnimi protitelesi proti ščitničnim antigenom pred uvedbo litija, in sicer hipotirozo pri približno 20% bolnikov, redkeje pa hipertirozo. Poleg tega litij vliva na imunski sistem in s tem na pojavnost avtoimunskih ščitničnih bolezni. Dolgotrajna terapija z litijem poveča nevarnost za nastanek motenj delovanja ščitnice. Zaključki. S prispevkom želimo opozoriti na raznolike vplive terapije z litijem na ščitnico. Priporočamo: 1.) oceno ščitnične morfologije in funkcije pred uvedbo terapije z litijem; 2.) redne polletne kontrole ščitnične morfologije in funkcije med terapijo z litijem; 3. ) zdravljenje bolnikov z golšo in bolnikov s hipotirozo z L-tiroksinom.
Descriptors		BIPOLAR DISORDER LITHIUM THYROID DISEASES GOITER HYPERTHYROIDISM HYPOTHYROIDISM THYROIDITIS