Management Challenges in a Child with Chronic Hyponatremia: Use of V2 Receptor Antagonist

Chronic hyponatremia is very rare in children and is often seen in the setting of congestive heart failure or liver failure in adults. Here, we report an 8-year-old child with hypothalamic glioma who presented with severe hyponatremia. Initial management consisted of fluid restriction. This was very...

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Main Authors: Sowmya Krishnan, Swapna Deshpande, Ashwini Mallappa, Gunda Divya, Pascale Lane, Anu Vishwanath, Rene Y. McNall-Knapp
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2017/3757423
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author Sowmya Krishnan
Swapna Deshpande
Ashwini Mallappa
Gunda Divya
Pascale Lane
Anu Vishwanath
Rene Y. McNall-Knapp
author_facet Sowmya Krishnan
Swapna Deshpande
Ashwini Mallappa
Gunda Divya
Pascale Lane
Anu Vishwanath
Rene Y. McNall-Knapp
author_sort Sowmya Krishnan
collection DOAJ
description Chronic hyponatremia is very rare in children and is often seen in the setting of congestive heart failure or liver failure in adults. Here, we report an 8-year-old child with hypothalamic glioma who presented with severe hyponatremia. Initial management consisted of fluid restriction. This was very difficult for the child to follow and the child developed bizarre drinking habits requiring intervention from child psychiatry. So therapy was initiated with low dose V2 receptor antagonist under close inpatient monitoring. While initial response was reassuring, her sodium levels tended to drift down with longer duration of treatment requiring us to increase the dose frequently. Her response to therapy and her stable clinical situation off therapy suggest that she may have reset osmostat.
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series Case Reports in Pediatrics
spelling doaj-art-e35c51296dda46769a53ac9ebcd8d2e92025-08-20T02:21:24ZengWileyCase Reports in Pediatrics2090-68032090-68112017-01-01201710.1155/2017/37574233757423Management Challenges in a Child with Chronic Hyponatremia: Use of V2 Receptor AntagonistSowmya Krishnan0Swapna Deshpande1Ashwini Mallappa2Gunda Divya3Pascale Lane4Anu Vishwanath5Rene Y. McNall-Knapp6Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USADepartment of Psychiatry, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USADepartment of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USADepartment of Radiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USADepartment of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USADepartment of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USADepartment of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USAChronic hyponatremia is very rare in children and is often seen in the setting of congestive heart failure or liver failure in adults. Here, we report an 8-year-old child with hypothalamic glioma who presented with severe hyponatremia. Initial management consisted of fluid restriction. This was very difficult for the child to follow and the child developed bizarre drinking habits requiring intervention from child psychiatry. So therapy was initiated with low dose V2 receptor antagonist under close inpatient monitoring. While initial response was reassuring, her sodium levels tended to drift down with longer duration of treatment requiring us to increase the dose frequently. Her response to therapy and her stable clinical situation off therapy suggest that she may have reset osmostat.http://dx.doi.org/10.1155/2017/3757423
spellingShingle Sowmya Krishnan
Swapna Deshpande
Ashwini Mallappa
Gunda Divya
Pascale Lane
Anu Vishwanath
Rene Y. McNall-Knapp
Management Challenges in a Child with Chronic Hyponatremia: Use of V2 Receptor Antagonist
Case Reports in Pediatrics
title Management Challenges in a Child with Chronic Hyponatremia: Use of V2 Receptor Antagonist
title_full Management Challenges in a Child with Chronic Hyponatremia: Use of V2 Receptor Antagonist
title_fullStr Management Challenges in a Child with Chronic Hyponatremia: Use of V2 Receptor Antagonist
title_full_unstemmed Management Challenges in a Child with Chronic Hyponatremia: Use of V2 Receptor Antagonist
title_short Management Challenges in a Child with Chronic Hyponatremia: Use of V2 Receptor Antagonist
title_sort management challenges in a child with chronic hyponatremia use of v2 receptor antagonist
url http://dx.doi.org/10.1155/2017/3757423
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