Lithium Carbonate Treatment of Mania Associated With Klinefelter's Syndrome

To the Editor.— Although manic symptoms are commonly believed to be the specific manifestation of the primary affective disorder mania, they may be associated with and often are secondary to other causes. 1 For example, Caroff 2 described a patient with Klinefelter's syndrome and bipolar affective illness and noted that at least eight other such cases appear in the literature (although with variable rigor of diagnostic documentation). We wish to report another such case, to alert physicians to the possibility of this association, and to suggest that the use of lithium carbonate may be appropriate and effective in this as well as other situations in which mania-like mental status changes are associated with or secondary to other causes (241:1011, 1979). Report of a Case.— A 25-year-old marriedn man with no prior psychiatric history was hospitalized in April 1974. For three weeks his family had noted him to be verbose, grandiose,