title: Pitfalls in Interventional Pain Medicine: Hyponatremia after DDAVP for a Patient with Von Willebrand Disease Undergoing an Epidural Steroid Injection.
abstract: Desmopressin (DDAVP), a synthetic analog of vasopressin, has been used in patients with von Willebrand disease (VWD), mild hemophilia A, and platelet dysfunction to reduce the risk of bleeding associated with surgical and interventional procedures. We report the case of a patient with VWD presenting with a bulging disc and radicular pain that underwent transforaminal epidural steroid injections. Her course was complicated with the interval development of headaches and dizziness symptomatic of moderate hyponatremia, likely due to excessive fluid intake. This report highlights a relatively rare side effect of DDAVP when used for prophylaxis in patients with VWD and reinforces the need for vigilance in these patients.
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
authors.forename: Talal W
authors.identifier: 0000-0002-3022-721X
authors.initials: TW
authors.lastname: Khan
authors.affiliation: Division of Medical Oncology, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
authors.forename: Abdulraheem
authors.identifier: 0000-0001-5293-4620
authors.initials: A
authors.lastname: Yacoub