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2017 ; 9
(3
): 288-292
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Tolvaptan Treatment in Children with Chronic Hyponatremia due to Inappropriate
Antidiuretic Hormone Secretion: A Report of Three Cases
#MMPMID28515029
Tuli G
; Tessaris D
; Einaudi S
; De Sanctis L
; Matarazzo P
J Clin Res Pediatr Endocrinol
2017[Sep]; 9
(3
): 288-292
PMID28515029
show ga
Hyponatremia is the most common electrolyte disorder among hospitalized patients
and it is sometimes considered as a poor outcome predictor. Its correction is
thus indicated, even in asymptomatic patients. The conventional treatment
consists of fluid restriction in presence of euvolemia or hypervolemia; loop
diuretics are used in some hypervolemic conditions such as cardiac heart failure,
liver cirrhosis and nephrotic syndrome, while intravenous isotonic or hypertonic
solutions are administered in hypovolemic conditions. The utilization of
demeclocycline and urea is not indicated in pediatric ages due to lack of data on
their toxicity and poor tolerance. Recently, a new therapeutic option has been
developed, a class of non-peptide arginine vasopressin receptor antagonists
called vaptans. Tolvaptan is the only such agent approved in Europe for the
treatment of hyponatremia caused by syndrome of inappropriate antidiuretic
hormone secretion (SIADH) in adults. In USA, tolvaptan and conivaptan have been
approved for treatment of euvolemic and hypervolemic hyponatremia. Few data are
so far available in paediatric patients, since only one trial has been registered
in Europe which includes children and adolescents, but this trial is still
ongoing. Here, we report three children with chronic hyponatremia due to SIADH in
which tolvaptan has been used successfully.
|Antidiuretic Hormone Receptor Antagonists/*therapeutic use
[MESH]