title: Conivaptan therapy in an infant with severe hyponatremia and congestive heart failure.
abstract: Conivaptan is a nonspecific arginine vasopressin receptor antagonist that has been used as therapy in adults who have hypervolemic hyponatremia due to congestive heart failure. Its use in children with congestive heart failure has not been reported. We describe the use of conivaptan in a 4-month-old infant girl with severe hypervolemic hyponatremia and heart failure. A therapeutic weight-based dose was extrapolated from the adult dose. Conivaptan therapy was administered for 48 hours, after which the patient recovered from her hyponatremia without untoward effects. Arginine vasopressin receptor antagonists such as conivaptan may be useful as therapy for hyponatremia associated with heart failure. Further studies are required before conivaptan can be recommended for routine use in children.
authors.affiliation: Division of Pediatric Cardiology, University of Texas Health Science Center at Houston, Houston, Texas 77030, USA. SahuR@email.chop.edu
authors.forename: Raj
authors.initials: R
authors.lastname: Sahu
authors.forename: Duraisamy
authors.initials: D
authors.lastname: Balaguru
authors.forename: Vandana
authors.initials: V
authors.lastname: Thapar
authors.forename: Ikram
authors.initials: I
authors.lastname: Haque
authors.forename: Chi
authors.initials: C
authors.lastname: Pham-Peyton
authors.forename: J Timothy
authors.initials: JT
authors.lastname: Bricker
mesh_terms: D001552:Benzazepines / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D007223:Infant; D009481:Neurophysins / Q000037:antagonists & inhibitors* / Q000378:metabolism; D011498:Protein Precursors / Q000037:antagonists & inhibitors* / Q000378:metabolism; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014667:Vasopressins / Q000037:antagonists & inhibitors* / Q000378:metabolism
chemical_list: C438657:AVP protein, human; D001552:Benzazepines; D006727:Hormone Antagonists; D009481:Neurophysins; D011498:Protein Precursors; C106389:conivaptan; D014667:Vasopressins
keywords: Antidiuretic agents/therapeutic use; conivaptan; heart failure/complications; hyponatremia/drug therapy; receptors, vasopressin/antagonists & inhibitors; risk factors; sodium/blood; treatment outcome