NDLI: Severe signs of hyponatremia secondary to desmopressin treatment for enuresis: a systematic review.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Lucchini, Barbara Simonetti, Giacomo D. Ceschi, Alessandro Lava, Sebastiano A. G. Faré, Pietro B. Bianchetti, Mario G.
Description	Country affiliation: Switzerland Author Affiliation: Lucchini B ( Integrated Department of Pediatrics, Ente Ospedaliero Cantonale Ticinese, and University of Bern, Switzerland.)
Abstract	OBJECTIVE: Dilutional hyponatremia is a serious adverse effect of desmopressin, a vasopressin analog that is widely prescribed to manage monosymptomatic enuresis. The presentation of hyponatremia, largely related to cerebral dysfunction, can include severe signs like altered mental status and seizures. METHODS: We reviewed the literature dealing with altered mental status or seizures in enuretic subjects on desmopressin. The retained publications included patients who were described individually, revealing data on mode of administration, further identifiable factors predisposing to hyponatremia, presentation and clinical course. RESULTS: We found 54 cases of hyponatremia secondary to desmopressin treatment presenting with altered mental status or seizures. In most cases the complication developed 14 days or less after starting desmopressin. An intranasal formulation had been used in 47 patients. Excess fluid intake was documented as a contributing factor in at least 22 cases. In 6 cases severe signs of hyponatremia developed in the context of intercurrent illnesses. CONCLUSION: Altered mental status or seizures are very rare but recognized complications of desmopressin in enuresis. This complication mostly develops in subjects managed with the intranasal formulation 14 days or less after starting the medication, following excess fluid intake and during intercurrent illnesses.
File Format	HTM / HTML
ISSN	14775131
Part	Pt B
Volume Number	9
e-ISSN	18734898
Journal	Journal of Pediatric Urology
Issue Number	6
Language	English
Publisher	Elsevier
Publisher Date	2013-12-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Urology Discipline Pediatrics Antidiuretic Agents Adverse Effects Deamino Arginine Vasopressin Enuresis Drug Therapy Hyponatremia Chemically Induced Diagnosis Administration & Dosage Humans Lethargy Seizures Severity Of Illness Index Journal Article Review
Content Type	Text
Resource Type	Article
Subject	Urology Pediatrics, Perinatology and Child Health

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