Massive Lithium Intoxication Associated with Diffuse Telogen Effluvium

The document reports a case of a 38-year-old woman who survived a massive lithium overdose, which led to a condition called diffuse telogen effluvium, a form of hair loss. The woman, who had bipolar affective disorders, ingested 120 tablets of Teralithe LP 400 mg, a lithium-based medication. She developed confusion and general and hemodynamic seizures. Fifteen days after the overdose, a diffuse hair loss was observed in the occipital region. The lithium levels in her blood were extremely high, with plasmatic and intraerythrocytic levels at 14.90 and 12.10 mmol/L respectively, 48 hours after ingestion. Continuous venovenous haemodialysis was performed for 3 days to clear the lithium from her system, and it took 8 days for the levels to drop below the limit of detection. Hair samples showed lithium concentrations of 1.83 and 2.17 ng/mg at the roots and tips respectively, and 60% of the hairs were in the telogen phase, indicating hair loss.