The therapeutic effect of oral desmopressin lyophilisate formulation in children with central diabetes insipidus

Hüseyin Anıl Korkmaz; Fulya Coşkunol; Vatan Barışık; Behzat Ozkan

doi:10.1515/jpem-2023-0203

Article

The therapeutic effect of oral desmopressin lyophilisate formulation in children with central diabetes insipidus

Hüseyin Anıl Korkmaz , Fulya Coşkunol , Vatan Barışık and Behzat Ozkan

Published/Copyright: September 4, 2023

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 36 Issue 10

Abstract

Objectives

We aimed to assess the efficacy of oral use of oral desamino-D-arginine-8-vasopressin lyophilisate (OLD) in children with central diabetes insipidus (CDI).

Methods

Clinical, laboratory, and imaging characteristics of twenty-five children with CDI treated with OLD were evaluated.

Results

Fourteen boys and eleven girls with a mean age of 52.37 months were evaluated. These children (mean weight and height at admission, 26.81 ± 14.8 kg vs. 92.52 ± 30 cm) presented with failure to thrive, irritability, prolonged fever, polyuria and hypernatremia (mean sodium level, 143.12 ± 8.6 mEq/L). At the time of hypernatremia, mean serum and urine osmolality were 298.2 ± 18 mOsm/kg and 160.20 ± 8.7 mOsm/kg, respectively. ADH levels were undetectable (<0.5 pmol/L) at admission in all cases. Oral administration of desmopressin lyophilisate (120 µg/tablet) was initiated at a dose of 5 μg/kg/day in two divided doses together with controlled water intake to avoid hyponatremia. Serum sodium levels normalised in a mean duration of 15.2 ± 16.4 h with a mean decline rate of 0.12 ± 0.04 mEq/L/h. Nine children needed rehospitalization because of hypernatremia due to non-compliance. Four episode of hyponatremia was observed. Weight gain and growth were normal during the mean follow-up duration of 37.79 ± 48.2 months.

Conclusions

Administration of OLD was practical and safe in the treatment of CDI in children with CNS malformations in this small retrospective series.

Keywords: central diabetes insipidus; children; oral desmopressin lyophilisate

Corresponding author: Hüseyin Anıl Korkmaz, MD, Department of Pediatrics, Division of Pediatric Endocrinology, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Türkiye, Phone: +90 0232 411 60 00, E-mail: hanilkorkmaz@gmail.com

Research ethics: The participants’ parents gave written, informed consent. The investigations were conducted in accordance with the principles of the Helsinki Declaration.
Informed consent: Informed consent was obtained from all individuals included in this study.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Research funding: None declared.

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Received: 2023-05-02

Accepted: 2023-08-15

Published Online: 2023-09-04

Published in Print: 2023-10-26

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Articles in the same Issue

https://doi.org/10.1515/jpem-2023-0203

Keywords for this article

central diabetes insipidus; children; oral desmopressin lyophilisate