title: Efficacy of COX-2 inhibitors in a case of congenital nephrogenic diabetes insipidus.
abstract: A 17-month-old boy presented with failure to thrive, polyuria, and vomiting. He had been diagnosed clinically with nephrogenic diabetes insipidus and treated by amiloride and hydrochlorothiazide combination without a satisfactory outcome at another center since 1 year of age. The diagnosis was confirmed by genetic analysis (AVPR2mutation), and the treatment was modified to include rofecoxib (a selective cyclooxygenase-2 inhibitor) in addition to hydrochlorothiazide and amiloride. This combination along with a low-salt diet resulted in a dramatic decrease in urinary free-water loss, while no side effect was noted. Because of prohibition of rofecoxib, it had to be substituted first by indomethacin and then by ibuprofen. However, both drugs were ineffective in controlling water diuresis. Thus, we had to replace these drugs by celecoxib (another selective cyclooxygenase-2 inhibitor). We conclude that the combination hydrochlorothiazide/amiloride/cyclooxygenase-2 inhibitor could be successfully used to treat congenital nephrogenic diabetes insipidus.
authors.affiliation: Dokuz Eylül University Medical Faculty, Department of Pediatrics, Izmir, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Soylu
authors.forename: Belde
authors.initials: B
authors.lastname: Kasap
authors.forename: Nilüfer
authors.initials: N
authors.lastname: Oğün
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Oztürk
authors.forename: Mehmet
authors.initials: M
authors.lastname: Türkmen
authors.forename: Lies
authors.initials: L
authors.lastname: Hoefsloot
authors.forename: Salih
authors.initials: S
authors.lastname: Kavukçu
mesh_terms: D000584:Amiloride / Q000008:administration & dosage; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage*; D004252:DNA Mutational Analysis; D018500:Diabetes Insipidus, Nephrogenic / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics*; D004232:Diuretics / Q000008:administration & dosage*; D005500:Follow-Up Studies; D040181:Genetic Diseases, X-Linked; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage; D007223:Infant; D007783:Lactones / Q000008:administration & dosage*; D008297:Male; D017483:Receptors, Vasopressin / Q000235:genetics*; D013450:Sulfones / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D004232:Diuretics; D007783:Lactones; D017483:Receptors, Vasopressin; D013450:Sulfones; D006852:Hydrochlorothiazide; C116926:rofecoxib; D000584:Amiloride; D051546:Cyclooxygenase 2