Bipolar affective disorder associated with thenar hypoplasia: is lithium safe?

[holt-oram syndrome]

Thenar hypoplasia has been described to occur as a part of radial longitudinal deficiency syndromes and occasionally related to Holt-Oram syndrome in which both cardiac and skeletal abnormalities co -occur . We describe a case with bilateral thenar hypoplasia , which resembles a milder variety of Holt-Oram syndrome , who developed bradycardia after exposure to lithium at therapeutic doses .