Lithium Carbonate Therapy of Aplastic Anemia

Abstract

A fifty-eight year old female with known aplastic anemia of four years duration was treated with lithium carbonate, 900 mgs. daily. Within fifteen days the hemoglobin stabilized and transfusions were not longer required. The white blood count rose from 2100/mm to 5400/mm and the neutrophil percentage rose from 27% to 73%. The platelet count which had been below 4000/mm³ for several months rose to 87,000/mm³. The lithium level ranged from 0.45 to 1.3 meq/L. Thirty days after the initiation of lithium carbonate the hemoglobin was 11.6 gms/dl, white blood count 5100/mm³ and platelet count 134,000/mm³. Over the succeeding four months the hemoglobin and white count remained stable and no transfusions were required. The platelet count gradually fell to 31,000/mm³ and the development of hypothyroidism was noted. The lithium level during this period was below 1.0 meq/L. An increased dose of lithium carbonate raised the lithium level to 1.07 meq/L and Synthroid was given. The platelet count subsequently rose to 64,000/mm³. Aside from the hypothyroidism the patient has suffered no significant side effects from the lithium carbonate therapy and is asymptomatic.