ESPE2023 Poster Category 1 Pituitary, Neuroendocrinology and Puberty (73 abstracts)
The Therapeutic Effect of Oral Desmopressin Lyophilisate Formulation in Children with Central Diabetes Insipidus
Huseyin Anil Korkmaz 1 , Fulya Coskunol 2 , Ahmet Gonullu 3 & Behzat Ozkan 1
1Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Department of Pediatrics, Division of Pediatric Endocrinology, izmir, Turkey. 2Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Department of Pediatrics, izmir, Turkey. 3Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Department of Pediatric, izmir, Turkey
Background: Experience with oral desamino-D-arginine-8-vasopressin lyophilisate (OLD) for central diabetes insipidus (CDI) in children with CNS malformations is limited.
Objective and hypotheses: We aimed to assess the efficacy of oral use of OLD in children with CDI.
Methods: Clinical, laboratory, and imaging characteristics of twenty-five children with CDI treated with OLD were evaluated.
Results: Thirteen boys and eleven girls with a mean age of 23 months were evaluated. These children presented with failure to thrive, irritability, prolonged fever, polyuria and hypernatremia. Clinical and laboratory characteristics of twenty-five children are shown in Table 1. 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. Nine children were rehospitalization because of hypernatremia due to non-compliance with OLD and recurrent infections. Four episode of hyponatremia was encountered.
| Age (months) Infants (age < 1 year) | 52.37 ± 47.83 1 |
| Female | 11 |
| Gestational age (weeks) | 35.46 ± 3.03 |
| Birth weight (grams) | 2463 ± 732 |
| Weight at admission (kilograms)* | 26.81± 14.8 |
| Weight SDS at admission | -0.11 ± 1.8 |
| Height at admission (cm) | 92.52 ± 30 |
| Height SDS at admission | -0.56± 1.4 |
| Body mass index at admission | 17.10± 12.14 |
| Body mass index SDS at admission | 0.27± 1.2 |
| Urine output at admission (mL/kg/hour) | 6.6 ± 1.4 |
| Serum sodium level (mEq/L) | 143.12± 8.6 |
| Serum osmolality (mOsm/kg) | 298.2 ± 18 |
| Urine osmolality (mOsm/kg) | 160.20 ± 8.7 |
| Serum ADH level (pmol/L) ** | <0.5 |
| DDAVP lyophilisate dose at discharge (µg/kg/day)* | 7.4 ± 14.2 |
| Decline duration of serum sodium (hours) | 15.2 ± 16.4 |
| Decline rate of serum sodium (mEq/L/hour) | 0.12 ± 0.04 |
| Decline duration of urine output (hours) | 48.6 ± 6.2 |
| Decline rate of urine output (mL/kg/hour) | 0.25 ± 0.14 |
| Duration of follow up (months)* | 37.79 ± 48.2 |
| Weight at the last visit (kilogram) | 31.48 ± 33 |
| Weight SDS at the last visit | -0.29 ± 1.4 |
| Height at the last visit (cm) | 103.3 ± 44 |
| Height SDS at the last visit | -0.97± 2.2 |
| Body mass index at the last visit | 19.03± 6.7 |
| Body mass index SDS at the last visit | 0.27± 1.2 |
| Data are presented as mean ± std dev. unless specified. | |
Conclusions: Administration of OLD was practical and safe in the treatment of CDI in children with CNS malformations in this small retrospective series.
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