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Tolvaptan is successful in treating inappropriate antidiuretic hormone secretion in infants

Marx-Berger, D; Milford, DV; Bandhakavi, M; Van't Hof, W; Kleta, R; Dattani, M; Bockenhauer, D; (2016) Tolvaptan is successful in treating inappropriate antidiuretic hormone secretion in infants. Acta Paediatrica , 105 (7) e334-e337. 10.1111/apa.13415. Green open access

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Abstract

AIM: Using fluid restriction to treat syndrome of inappropriate antidiuretic hormone secretion (SIADH) in infants is potentially hazardous, as fluid and caloric intake are connected. Antagonists for the type 2 vasopressin receptor have demonstrated efficacy in adult patients with SIADH, but evidence in children is lacking. We reviewed our experience from two cases in the UK. METHODS: This was a retrospective review of the clinical data on two patients diagnosed with SIADH in infancy and treated with tolvaptan, an oral vasopressin receptor antagonist. RESULTS: Persistent hyponatraemia was noted in both patients in the first month of life and eventually led to SIADH diagnoses. Initial salt supplementation in one patient resulted in severe hypertension, treated with four anti-hypertensive drugs. Tolvaptan was commenced at two and four months of age, respectively, and was associated with normalisation of plasma sodium values and blood pressure without the need for anti-hypertensive treatment. There was transient hypernatraemia in one patient, which was normalised with a dose reduction. Tolvaptan was administered by crushing the tablet and mixing it with water. CONCLUSION: Tolvaptan provided effective treatment for SIADH in both infants and could be administered orally.

Type: Article
Title: Tolvaptan is successful in treating inappropriate antidiuretic hormone secretion in infants
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/apa.13415
Publisher version: http://dx.doi.org/10.1111/apa.13415
Language: English
Additional information: Copyright © 2016 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd. This is the peer reviewed version of the following article: [Marx-Berger, D., Milford, D. V., Bandhakavi, M., van't Hoff, W., Kleta, R., Dattani, M. and Bockenhauer, D. (2016), Tolvaptan is successful in treating inappropriate antidiuretic hormone secretion in infants. Acta Paediatrica, 105: e334–e337. doi: 10.1111/apa.13415], which has been published in final form at http://dx.doi.org/10.1111/apa.13415. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Keywords: Aquaretic; Hyponatraemia; Infant; SIADH; Tolvaptan
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Renal Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Genetics and Genomic Medicine Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1481506
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