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72 year old Asian female with multiple microcysts or nodular calcifications in a capsular or subcapsular location.
Consequence of lithium therapy is the most likely diagnosis
Ashley Davidoff MD
018 72F Asian renal capsular calcification
72 year old Asian female with multiple microcysts or nodular calcifications in a capsular or subcapsular location.
Consequence of lithium therapy is the most likely diagnosis
Ashley Davidoff MD
020 72F Asian renal capsular calcification
72 year old Asian female with multiple microcysts or nodular calcifications in a capsular or subcapsular location.  Arterial calcifications are also present.
Consequence of lithium therapy is the most likely diagnosis
Ashley Davidoff MD
019 72F Asian renal capsular calcification

A Second Case

51 year old female with bipolar disorder on Lithium
CT shows numerous punctate calcifications in the cortex
and medulla bilaterally. Given history of lithium usage, CT appearance can be
seen with lithium-induced renal disease.
Ashley Davidoff The CommonVein.net
51 year old female with bipolar disorder on Lithium
CT shows numerous punctate calcifications in the cortex
and medulla bilaterally. Given history of lithium usage, CT appearance can be
seen with lithium-induced renal disease.
Ashley Davidoff The CommonVein.net
Echogenic kidneys with numerous punctate echogenic foci in the cortex
and medulla. Ct showed multiple punctate calcifications Given history of lithium usage, sonographic appearance can be
seen with lithium-induced renal disease.
Ashley Davidoff The CommonVein.net

Lithium used in the treatment of bipolar disorder.

    • renal toxicity
    • impaired urinary concentrating ability
    • natriuresis,
    • renal tubular acidosis,
    • tubulointerstitial nephritis

progressing to chronic kidney disease and hypercalcemia.

most common adverse effect is

nephrogenic diabetes insipidus, (20-40% of patients within weeks of initiation of Rx.

 Lithium nephropathy is uncommon ,occurring in 15% s(3)

Radiology

  •  innumerable micro cysts randomly distributed in BOTH
    • cortex and medulla or predominantly cortex are
    • usually 1-2 mm in diameter.
    • Cysts arise from distal tubular structures and collecting ducts.
    • Best seen on T2W MRI images.
Magnetic resonance image in a 68-year-old patient shows abundant microcysts in the cortical and medullary regions of both kidneys. Source: Farres MT, et al. Chronic lithium nephropathy: MR imaging for diagnosis. Radiology 2003; 229: 570-574