Low-Dose Tolvaptan for the Treatment of Dilutional Hyponatremia in Cirrhosis: A Case Report and Literature Review

Dilutional hyponatremia is common in decompensated cirrhosis and can be successfully treated by tolvaptan, a vasopressin V2-receptor antagonist. Data were lacking regarding the effects of tolvaptan on cirrhotic patients with a Child-Pugh score of >10 and a serum sodium concentration of <120 mm...

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Main Authors: Guo Shen, Hainv Gao
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Hepatology
Online Access:http://dx.doi.org/10.1155/2014/795261
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author Guo Shen
Hainv Gao
author_facet Guo Shen
Hainv Gao
author_sort Guo Shen
collection DOAJ
description Dilutional hyponatremia is common in decompensated cirrhosis and can be successfully treated by tolvaptan, a vasopressin V2-receptor antagonist. Data were lacking regarding the effects of tolvaptan on cirrhotic patients with a Child-Pugh score of >10 and a serum sodium concentration of <120 mmol/L. We report a case of forties man with a 20-year history of chronic hepatitis B presenting with yellow urine and skin. Laboratory tests demonstrated prolonged prothrombin time, markedly elevated total bilirubin, severe hyponatremia, and a Child-Pugh score of >10. The patient was diagnosed with dilutional hyponatremia and was treated with recommended dosage tolvaptan at first. The serum concentration of sodium recover but the patient felt obviously thirsty. As the dosage of tolvaptan was decreased accordingly from 15 mg to 5 mg, the patient still maintained the ideal concentration of serum sodium. This case emphasizes that cirrhotic patient with higher Child-Pugh scores and serum sodium concentration of <120 mmol/L can be treated with lower dose of tolvaptan.
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spelling doaj-art-fc0f4761c2a240a3a93ad4c8dcf529c02025-02-03T01:23:54ZengWileyCase Reports in Hepatology2090-65872090-65952014-01-01201410.1155/2014/795261795261Low-Dose Tolvaptan for the Treatment of Dilutional Hyponatremia in Cirrhosis: A Case Report and Literature ReviewGuo Shen0Hainv Gao1The First Hospital of Zhuji, 122nd Huansha Nan Road, Zhuji 311800, ChinaThe State Key Laboratory of Diagnosis and Treatment for Infectious Disease, College of Medicine, The First Affiliated Hospital, Zhejiang University, 79th Qingchun Road, Hangzhou 310003, ChinaDilutional hyponatremia is common in decompensated cirrhosis and can be successfully treated by tolvaptan, a vasopressin V2-receptor antagonist. Data were lacking regarding the effects of tolvaptan on cirrhotic patients with a Child-Pugh score of >10 and a serum sodium concentration of <120 mmol/L. We report a case of forties man with a 20-year history of chronic hepatitis B presenting with yellow urine and skin. Laboratory tests demonstrated prolonged prothrombin time, markedly elevated total bilirubin, severe hyponatremia, and a Child-Pugh score of >10. The patient was diagnosed with dilutional hyponatremia and was treated with recommended dosage tolvaptan at first. The serum concentration of sodium recover but the patient felt obviously thirsty. As the dosage of tolvaptan was decreased accordingly from 15 mg to 5 mg, the patient still maintained the ideal concentration of serum sodium. This case emphasizes that cirrhotic patient with higher Child-Pugh scores and serum sodium concentration of <120 mmol/L can be treated with lower dose of tolvaptan.http://dx.doi.org/10.1155/2014/795261
spellingShingle Guo Shen
Hainv Gao
Low-Dose Tolvaptan for the Treatment of Dilutional Hyponatremia in Cirrhosis: A Case Report and Literature Review
Case Reports in Hepatology
title Low-Dose Tolvaptan for the Treatment of Dilutional Hyponatremia in Cirrhosis: A Case Report and Literature Review
title_full Low-Dose Tolvaptan for the Treatment of Dilutional Hyponatremia in Cirrhosis: A Case Report and Literature Review
title_fullStr Low-Dose Tolvaptan for the Treatment of Dilutional Hyponatremia in Cirrhosis: A Case Report and Literature Review
title_full_unstemmed Low-Dose Tolvaptan for the Treatment of Dilutional Hyponatremia in Cirrhosis: A Case Report and Literature Review
title_short Low-Dose Tolvaptan for the Treatment of Dilutional Hyponatremia in Cirrhosis: A Case Report and Literature Review
title_sort low dose tolvaptan for the treatment of dilutional hyponatremia in cirrhosis a case report and literature review
url http://dx.doi.org/10.1155/2014/795261
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