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Severe hyponatremia due to desmopressin
H Brendan Kelleher1, Sean O Henderson
1Department of Emergency Medicine, Keck/USC School of Medicine, Los Angeles, California 90033, USA.
The Journal of Emergency Medicine
|January 26, 2006
Summary
Nasal desmopressin (DDAVP) can cause severe hyponatremia, even in patients with few symptoms. This case highlights the importance of monitoring electrolytes during DDAVP treatment.
Area of Science:
- Nephrology
- Endocrinology
Background:
- Nasal desmopressin (DDAVP), an antidiuretic hormone analogue, is widely used for diabetes insipidus, polyuria, and nocturnal enuresis.
- While generally safe, DDAVP can lead to significant electrolyte disturbances, particularly hyponatremia.
Observation:
- A case report details a 52-year-old woman who developed severe, hypotonic hyponatremia (104 mEq/L) after a gastrointestinal illness while using nasal DDAVP.
- The patient experienced minimal symptoms despite the profound electrolyte imbalance.
Findings:
- This case illustrates a rare instance of severe desmopressin-associated hyponatremia.
- The patient's hyponatremia was successfully corrected, with the management approach detailed in the report.
Implications:
- Clinicians should be vigilant for the potential of severe hyponatremia associated with desmopressin therapy, even in minimally symptomatic individuals.
- Awareness of this risk is crucial for prompt diagnosis and appropriate management of DDAVP-induced electrolyte imbalances.