Reactions 639 - 22 Feb 1997

SDesmopressin

Hyponatraemia and coma following intranasaladministration in a child: case report

Hyponatraemia and coma occurred in an 11-year-old boyafter he was treated with intranasal desmopressin [dosage notstated] for nocturnal enuresis.

The patient was also receiving imipramine andpseudoephedrine. He developed hyponatraemic convulsionsand coma after 2 doses of intranasal desmopressin. [Treatmentand patient outcome not stated.]

Author comment: ‘Similar cases have been reported in theliterature with desmopressin alone as well as with combineddesmopressin and imipramine. These cases highlight the needfor careful monitoring of fluid intake when desmopressin isused for this indication.’ Also, the risk of hyponatraemia withdesmopressin can be minimised by avoiding the concomitantuse of agents that may enhance the risk of hyponatraemia orrelease antidiuretic hormone, namely, carbamazepine,chlorpromazine and tricyclic antidepressants, and particularlyimipramine.’Mehta U. Hyponatraemic convulsions and coma in a patient with enuresis treatedwith desmopressin. SAMJ South African Medical Journal 87: 79, Jan 1997 - SouthAfrica 800496152

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Reactions 22 Feb 1997 No. 6390114-9954/10/0639-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved