Intranasal desmopressin-associated hyponatremia: a case report and literature review.
We present a case of a 29-year-old woman with a long history of nocturnal enuresis who developed symptomatic hyponatremia from water intoxication shortly after beginning desmopressin. A MEDLINE search in the English language revealed 13 prior case reports. All patients presented with seizure, mental status changes, or both. Two distinct presentations occurred: one group of patients maintained a stable course with desmopressin and developed symptoms related to an outside factor. The other group of patients were new to desmopressin and had a profound water intoxication response from its use. While the underlying cause was from simple overhydration, the quickness of this unanticipated adverse effect is noteworthy. The importance of counseling to ensure a family's and a patient's understanding of the effects of desmopressin as well as monitoring electrolytes periodically may help identify and prevent this serious iatrogenic complication.
Bernstein
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Department of Family Practice, Womack Army Medical Center, Fort Bragg, North Carolina.
Williford
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D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003894:Deamino Arginine Vasopressin / Q000009:adverse effects* / Q000627:therapeutic use; D004775:Enuresis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced* / Q000517:prevention & control; D007223:Infant; D008297:Male; D012076:Renal Agents / Q000009:adverse effects* / Q000627:therapeutic use; D014869:Water Intoxication / Q000139:chemically induced / Q000517:prevention & control
D012076:Renal Agents; D003894:Deamino Arginine Vasopressin