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European Journal of Pediatrics

, Volume 160, Issue 3, pp 159–162 | Cite as

Cerebral oedema in enuretic children during low-dose desmopressin treatment: a preventable complication

  • Jan Lebl
  • Monika Kolská
  • Andrea Zavacká
  • Jan Eliášek
  • Josef Gut
  • Jiří Biolek
ORIGINAL PAPER

Abstract

Seven cases of cerebral oedema have been observed in enuretic children during low-dose desmopressin (DDAVP) treatment given in a dose of 7–21 μg daily in the Czech Republic between 1995 and 1999, after the drug started to be marketed for this indication and delivered in simple bottles with a dropper. All seven children (age 5–11 years, four boys) experienced a period of unconsciousness but all recovered without sequelae. In most cases, safety measures were underestimated and natraemia was not regularly controlled. Two children developed cerebral oedema after excessive water intake in preparation for uroflowmetry, another one drank much during a hot summer day, in one diabetes insipidus was not recognised and two children were clearly non-compliant with reduced fluid intake on a long-term basis. Only in one child, no risk factor was found.

Conclusion Proper selection and instruction of patients is needed to avert cerebral oedema during treatment with desmopressin for nocturnal enuresis.

Key words Cerebral oedema Desmopressin Enuresis Hyponatraemia Water intoxication 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • Jan Lebl
    • 1
  • Monika Kolská
    • 1
  • Andrea Zavacká
    • 2
  • Jan Eliášek
    • 3
  • Josef Gut
    • 4
  • Jiří Biolek
    • 5
  1. 1.Department of Paediatrics, 3rd Faculty of Medicine, Charles University, Vinohradská 159, 100 81 Praha 10, Czech Republic e-mail: lebl@fnkv.cz Tel.: +420-2-67162561; Fax: +420-2-72736326
  2. 2.2nd Department of Paediatrics, 2nd Faculty of Medicine, Charles University, Vúvalu 84, 150 06 Praha 5, Czech Republic
  3. 3.Department of Paediatrics, District Hospital, Český Krumlov, Czech Republic
  4. 4.Department of Paediatrics, District Hospital, Česká Lípa, Czech Republic
  5. 5.Department of Paediatrics, District Hospital, Most, Czech Republic

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