Transient diabetes insipidus in a preterm neonate and the challenge of desmopressin dosing

Danielle C M Van der Kaay; Willemijn J M Van Heel; Jeroen Dudink; Erica L T van den Akker

doi:10.1515/jpem-2013-0305

Transient diabetes insipidus in a preterm neonate and the challenge of desmopressin dosing

Danielle C M Van der Kaay, Willemijn J M Van Heel, Jeroen Dudink, Erica L T van den Akker

Birth Center Neonatology - Medical

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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.

Original language	English
Pages (from-to)	769-71
Number of pages	3
Journal	Journal of Pediatric Endocrinology & Metabolism
Volume	27
Issue number	7-8
DOIs	https://doi.org/10.1515/jpem-2013-0305
Publication status	Published - Jul 2014

Keywords

Administration, Intranasal
Cerebral Hemorrhage
Deamino Arginine Vasopressin
Diabetes Insipidus
Female
Humans
Hydrocephalus
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases

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title = "Transient diabetes insipidus in a preterm neonate and the challenge of desmopressin dosing",

abstract = "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 = "Administration, Intranasal, Cerebral Hemorrhage, Deamino Arginine Vasopressin, Diabetes Insipidus, Female, Humans, Hydrocephalus, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases",

author = "{Van der Kaay}, {Danielle C M} and {Van Heel}, {Willemijn J M} and Jeroen Dudink and {van den Akker}, {Erica L T}",

year = "2014",

month = jul,

doi = "10.1515/jpem-2013-0305",

language = "English",

volume = "27",

pages = "769--71",

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number = "7-8",

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T1 - Transient diabetes insipidus in a preterm neonate and the challenge of desmopressin dosing

AU - Van der Kaay, Danielle C M

AU - Van Heel, Willemijn J M

AU - Dudink, Jeroen

AU - van den Akker, Erica L T

PY - 2014/7

Y1 - 2014/7

N2 - 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.

AB - 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.

KW - Administration, Intranasal

KW - Cerebral Hemorrhage

KW - Deamino Arginine Vasopressin

KW - Diabetes Insipidus

KW - Female

KW - Humans

KW - Hydrocephalus

KW - Infant, Newborn

KW - Infant, Premature

KW - Infant, Premature, Diseases

U2 - 10.1515/jpem-2013-0305

DO - 10.1515/jpem-2013-0305

M3 - Article

C2 - 24670345

SN - 0334-018X

VL - 27

SP - 769

EP - 771

JO - Journal of Pediatric Endocrinology & Metabolism

JF - Journal of Pediatric Endocrinology & Metabolism

IS - 7-8

ER -

Transient diabetes insipidus in a preterm neonate and the challenge of desmopressin dosing

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