A 31-year-old woman with bipolar disorder started lithium 6 months ago. She now reports excessive thirst and polyuria. Vital signs show HR 78/min, BP 118/76 mmHg, RR 14/min. Labs reveal serum sodium 148 mEq/L and serum osmolality 305 mOsm/kg. Urine osmolality remains inappropriately low at 210 mOsm/kg despite desmopressin administration. She denies fever or recent infections. Which adverse effect of lithium best explains these findings?
- A)SIADH
- B)Central diabetes insipidus
- C)Nephrogenic diabetes insipidusGABARITO
- D)Fanconi syndrome
- E)Acute tubular necrosis
Explicação
Lithium can cause nephrogenic diabetes insipidus by impairing collecting duct responsiveness to ADH. As a result, urine remains dilute even after desmopressin administration, and patients develop polyuria, polydipsia, and hypernatremia. Ver explicação completa e trilha adaptativa →