Management of central diabetes insipidus with oral desmopressin lyophilisate in infants.
OBJECTIVE
To assess the efficiency of oral desmopressin lyophilisate (ODL) in neonatal central diabetes insipidus (CDI).


METHODS
The characteristics of four newborns with CDI treated with ODL were evaluated.


RESULTS
Four newborns with polyuria and hypernatremia were included [male, 2 (50%); mean postnatal age, 19±17 days]. At the time of hypernatremia, the mean serum and urine osmolality values were 310±16 and 179±48 mOsm/kg, respectively. Antidiuretic hormone levels were undetectable (<0.5 pmol/L) in all cases. Magnetic resonance imaging revealed anatomical malformations in all cases. ODL (60 μg/tablet) dissolved in water (3-5 mL) was initiated with a dose of 5 μg/kg/day in two equal doses, together with limitation of water intake to avoid hyponatremia. Serum sodium levels returned to normal in a mean duration of 58±9.9 h with a mean decline rate of 0.37±0.1 mEq/L/h after desmopressin administration. Rehospitalization was required for one of the infants because of hypernatremia due to non-compliance. No episode of hyponatremia was encountered. Weight gain and growth of the infants were normal during the mean follow-up duration of 8.5±1 months.


CONCLUSIONS
ODL appears to be practical and safe in the treatment of CDI during the first year of life.
Hüseyin Anıl
HA
Korkmaz
Korcan
K
Demir
Fatma Kaya
FK
Kılıç
Demet
D
Terek
Sertaç
S
Arslanoğlu
Ceyhun
C
Dizdarer
Behzat
B
Ozkan
D000284:Administration, Oral; D050034:Antidiuretic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage / Q000627:therapeutic use*; D020790:Diabetes Insipidus, Neurogenic / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D006955:Hypernatremia / Q000188:drug therapy* / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011141:Polyuria / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin