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Licensed Unlicensed Requires Authentication Published by De Gruyter May 22, 2014

Management of central diabetes insipidus with oral desmopressin lyophilisate in infants

  • Hüseyin Anıl Korkmaz EMAIL logo , Korcan Demir , Fatma Kaya Kılıç , Demet Terek , Sertaç Arslanoğlu , Ceyhun Dizdarer and Behzat Özkan

Abstract

Aim: To assess the efficiency of oral desmopressin lyophilisate (ODL) in neonatal central diabetes insipidus (CDI).

Methods: The characteristics of four newborns with CDI treated with ODL were evaluated.

Results: Four newborns with polyuria and hypernatremia were included [male, 2 (50%); mean postnatal age, 19±17 days]. At the time of hypernatremia, the mean serum and urine osmolality values were 310±16 and 179±48 mOsm/kg, respectively. Antidiuretic hormone levels were undetectable (<0.5 pmol/L) in all cases. Magnetic resonance imaging revealed anatomical malformations in all cases. ODL (60 μg/tablet) dissolved in water (3–5 mL) was initiated with a dose of 5 μg/kg/day in two equal doses, together with limitation of water intake to avoid hyponatremia. Serum sodium levels returned to normal in a mean duration of 58±9.9 h with a mean decline rate of 0.37±0.1 mEq/L/h after desmopressin administration. Rehospitalization was required for one of the infants because of hypernatremia due to non-compliance. No episode of hyponatremia was encountered. Weight gain and growth of the infants were normal during the mean follow-up duration of 8.5±1 months.

Conclusions: ODL appears to be practical and safe in the treatment of CDI during the first year of life.


Corresponding author: Hüseyin Anıl Korkmaz, Division of Pediatric Endocrinology, Dr. Behcet Uz Children Disease and Surgery Training and Research Hospital, Alsancak, 35210 Izmir, Turkey, Phone: +90 232 489 63 18, Fax: +90 232 489 23 15, E-mail:

References

1. Maghnie M, Cosi G, Genovese E, Manca-Bitti ML, Cohen A, et al. Central diabetes insipidus in children and young adults. N Engl J Med 2000;343:998–1007.10.1056/NEJM200010053431403Search in Google Scholar PubMed

2. Molnar Z, Sotiridou E, Dixon H, Ogilvy-Stuart A. Transient diabetes insipidus in a very-low-birthweight preterm infant with intraventricular haemorrhage. Acta Paediatr 2012;101:389–90.10.1111/j.1651-2227.2012.02756.xSearch in Google Scholar PubMed

3. Rivas-Crespo MF, Miñones-Suárez L, G-Gallarza SS. Rare neonatal diabetes insipidus and associated late risks: case report. BMC Pediatr 2012;12:56.10.1186/1471-2431-12-56Search in Google Scholar PubMed PubMed Central

4. Lee YJ, Huang FY, Shen EY, Kao HA, Ho MY, et al. Neurogenic diabetes insipidus in children with hypoxic encephalopathy: six new cases and a review of the literature. Eur J Pediatr 1996;155:245–8.10.1007/BF01953946Search in Google Scholar PubMed

5. Atasay B, Berberoğlu M, Günlemez A, Evliyaoğlu O, Adiyaman P, et al. Management of central diabetes insipidus with oral desmopressin in a premature neonate. J Pediatr Endocrinol Metab 2004;17:227–30.10.1515/JPEM.2004.17.2.227Search in Google Scholar PubMed

6. Di Iorgi N, Napoli F, Allegri AE, Olivieri I, Bertelli E, et al. Diabetes insipidus – diagnosis and management. Horm Res Paediatr 2012;77:69–84.10.1159/000336333Search in Google Scholar PubMed

7. Robson WL, Leung AK, Norgaard JP. The comparative safety of oral versus intranasal desmopressin for the treatment of children with nocturnal enuresis. J Urol 2007;178:24–30.10.1016/j.juro.2007.03.015Search in Google Scholar PubMed

8. De Guchtenaere A, Van Herzeele C, Raes A, Dehoorne J, Hoebeke P, et al. Oral lyophylizate formulation of desmopressin: superior pharmacodynamics compared to tablet due to low food interaction. J Urol 2011;185:2308–13.10.1016/j.juro.2011.02.039Search in Google Scholar PubMed

9. Stick SM, Betts PR. Oral desmopressin in neonatal diabetes insipidus. Arch Dis Child 1987;62:1177–8.10.1136/adc.62.11.1177Search in Google Scholar PubMed PubMed Central

10. Özaydin E, Aycan Z, Yusufoğlu AM, Cetinkaya E, Ergen S, et al. Management of central diabetes insipidus with oral desmopressin in a patient with ectrodactyly and cleft lip/palate (ECP) syndrome. Turk J Pediatr 2009;51:89–93.Search in Google Scholar

11. Cheetham T, Baylis PH. Diabetes insipidus in children: pathophysiology, diagnosis and management. Paediatr Drugs 2002;4:785–96.10.2165/00128072-200204120-00003Search in Google Scholar PubMed

12. Raine JE, Donaldson MD, Gregory JW, Vliet GV. Salt and water balance. In: Raine JE, Donaldson MD, Gregory JW, Vliet GV, editors. Practical endocrinology and diabetes in children, 3rd ed. Oxford: Wiley-Blackwell, 2011:174–87.Search in Google Scholar

13. Stapleton G, DiGeronimo RJ. Persistent central diabetes insipidus presenting in a very low birth weight infant successfully managed with intranasal desmopressin. J Perinatol 2000;2:132–4.10.1038/sj.jp.7200308Search in Google Scholar PubMed

14. Masera N, Grant DB, Stanhope R, Preece MA. Diabetes insipidus with impaired osmotic regulation in septo-optic dysplasia and agenesis of the corpus callosum. Arch Dis Child 1994;70:51–3.10.1136/adc.70.1.51Search in Google Scholar PubMed PubMed Central

15. Tawa R, Kaino Y, Ito T, Goto Y, Kida K, et al. A case of Kabuki make-up syndrome with central diabetes insipidus and growth hormone neurosecretory dysfunction. Acta Paediatr Jpn 1994;36:412–5.10.1111/j.1442-200X.1994.tb03212.xSearch in Google Scholar

16. Van Gool S, de Zegher F, de Vries LS, Vanderschueren- Lodeweyckx M, Devlieger H, et al. Alobar holoprosencephaly, diabetes insipidus and coloboma without craniofacial abnormalities: a case report. Eur J Pediatr 1990;149:621–2.10.1007/BF02034747Search in Google Scholar PubMed

17. Yagi H, Nagashima K, Miyake H, Tamai S, Onigata K, et al. Familial congenital hypopituitarism with central diabetes insipidus. J Clin Endocrinol Metab 1994;78:884–9.Search in Google Scholar

18. Porterfield SP, Henrich CE. The role of thyroid hormones in prenatal and neonatal neurological development – current perspectives. Endocr Rev 1993;14:94–106.Search in Google Scholar

19. American Academy of Pediatrics, Rose SR; Section on Endocrinology and Committee on Genetics, American Thyroid Association, Brown RS; Public Health Committee, Lawson Wilkins Pediatric Endocrine Society, Foley T, Kaplowitz PB, Kaye CI, et al. Update of newborn screening and therapy for congenital hypothyroidism. Pediatrics 2006;117:2290–303.10.1542/peds.2006-0915Search in Google Scholar PubMed

20. Muglia LJ, Majzoub JA. Disorders of the posterior pituitary. In: Sperling MA, editor. Pediatric endocrinology, 3rd ed. Philadelphia: Saunders, 2008:356–73.Search in Google Scholar

21. Vande Walle J, Stockner M, Raes A, Norgaard JP. Desmopressin 30 years in clinical use: a safety review. Curr Drug Saf 2007;2:232–8.10.2174/157488607781668891Search in Google Scholar PubMed

Received: 2013-9-12
Accepted: 2014-4-17
Published Online: 2014-5-22
Published in Print: 2014-9-20

©2014 by De Gruyter

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