Medline ® Abstracts for References 33-35
of 'Nocturnal enuresis in children: Management'
Dangers of intranasal desmopressin for nocturnal enuresis.
Bamford MF, Cruickshank G
J R Coll Gen Pract. 1989;39(325):345.
Hyponatraemia and cerebral convulsion due to short term DDAVP therapy for control of enuresis nocturna.
Schwab M, Wenzel D, Ruder H
Eur J Pediatr. 1996;155(1):46.
UNLABELLED: Desmopressin (DDAVP) is frequently used in the treatment of primary isolated enuresis nocturna if other approaches have failed. We report a further case of hyponatraemia and cerebral convulsion due to water intoxication after intranasal DDAVP application by a 6 year-old boy with enuresis.
CONCLUSION: Although adverse reactions in DDAVP (e.g. hyponatraemia) are rare, it should not be considered as the first choice treatment of enuresis nocturna and only be used with caution.
Universitätskinderklinik, Erlangen, Germany.
Intranasal desmopressin-associated hyponatremia: a case report and literature review.
Bernstein SA, Williford SL
J Fam Pract. 1997;44(2):203.
We present a case of a 29-year-old woman with a long history of nocturnal enuresis who developed symptomatic hyponatremia from water intoxication shortly after beginning desmopressin. A MEDLINE search in the English language revealed 13 prior case reports. All patients presented with seizure, mental status changes, or both. Two distinct presentations occurred: one group of patients maintained a stable course with desmopressin and developed symptoms related to an outside factor. The other group of patients were new to desmopressin and had a profound water intoxication response from its use. While the underlying cause was from simple overhydration, the quickness of this unanticipated adverse effect is noteworthy. The importance of counseling to ensure a family's and a patient's understanding of the effects of desmopressin as well as monitoring electrolytes periodically may help identify and prevent this serious iatrogenic complication.
Department of Family Practice, Womack Army Medical Center, Fort Bragg, North Carolina.