Transient diabetes insipidus in a preterm neonate and the challenge of desmopressin dosing
Background: As neonatal central diabetes insipidus is rare in preterm neonates with intraventricular hemorrhage (IVH), very little is known about dosing and the route of administration of desmopressin treatment.Case report: We present a preterm neonate born at 29 weeks' gestation. Within 24 h, she developed bilateral IVH with subsequent post-hemorrhagic hydrocephalus. On the 3rd postnatal day, she developed diabetes insipidus for which she was intranasally administered 0.2 mg desmopressin. This resulted in oliguria with several hours of anuria and a 25-point drop in sodium levels within 15 h. Conclusion: The determination of the desmopressin dose in a preterm neonate is a challenge and there is no consistent literature about the dosing or the route of administration. We suggest starting with a low dose of intranasal desmopressin (0.05-0.1 μg) and titrate in accordance with clinical and laboratory parameters.
|Keywords||Desmopressin, Diabetes insipidus, Preterm|
|Persistent URL||dx.doi.org/10.1515/jpem-2013-0305, hdl.handle.net/1765/104823|
|Journal||Journal of Pediatric Endocrinology & Metabolism|
van der Kaay, D.C.M, van Heel, W.J.M, Dudink, J, & van den Akker, E.L.T. (2014). Transient diabetes insipidus in a preterm neonate and the challenge of desmopressin dosing. Journal of Pediatric Endocrinology & Metabolism, 27(7-8), 769–771. doi:10.1515/jpem-2013-0305