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

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Published/Copyright: March 26, 2014

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.


Corresponding author: Danielle C.M. Van der Kaay, MD, PhD, Department of Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands, E-mail:

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Received: 2013-7-20
Accepted: 2014-2-18
Published Online: 2014-3-26
Published in Print: 2014-7-1

©2014 by Walter de Gruyter Berlin/Boston

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