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Terlipressin-induced hyponatremic seizure
Jong Jin Hyun1, Yeon Seok Seo, Kwang Gyun Lee
1Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, South Korea.
Scandinavian Journal of Gastroenterology
|March 23, 2010
Summary
Terlipressin, used for variceal bleeding, can rarely cause severe hyponatremia and seizures. Monitoring electrolytes during terlipressin therapy is crucial due to this potential side effect.
Area of Science:
- Internal Medicine
- Pharmacology
- Gastroenterology
Background:
- Terlipressin is a vasopressin analog used to manage variceal bleeding.
- It is generally considered to have a favorable safety profile compared to vasopressin.
- Rare side effects, including hyponatremia and seizures, have been reported.
Observation:
- A case study documented severe hyponatremia and generalized seizure in a patient receiving terlipressin infusion.
- The patient's serum sodium levels dropped significantly from 141 mmol/l to 114 mmol/l within four days of terlipressin initiation.
- Serum osmolality also decreased, indicating a state of dilutional hyponatremia.
Findings:
- The induced hyponatremia was refractory to hypertonic saline treatment.
- Discontinuation of terlipressin led to a rapid normalization of serum sodium levels.
- This suggests a direct causal link between terlipressin infusion and the observed hyponatremia.
Implications:
- Careful monitoring of electrolyte levels, particularly serum sodium, is essential during terlipressin therapy.
- Clinicians should be vigilant for signs of hyponatremia in patients treated with terlipressin.
- This case highlights the importance of considering drug-induced side effects in complex clinical presentations.
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