Reactions 1461, p5 - 20 Jul 2013

SAceclofenac/desmopressin

Acute severe hyponatraemia: case reportA 46-year-old man developed acute, severe hyponatraemia

while receiving desmopressin and aceclofenac.The man was admitted to hospital with obtundation,

lethargy and loss of consciousness. He had central diabetesinsipidus and had been receiving intranasal desmopressin10µg per day in two divided doses for 18 years. He denied anyalteration to this dosage. Dizziness, headache, nausea andvomiting had developed 3 days before admission. A physicalexamination was normal. Laboratory tests showed a sodiumlevel of 113 mEq/L. Further questioning revealed that he hadalso been receiving aceclofenac 200mg per day for 1 week[route not stated] due to lumbar pain related to weight-lifting.

The man’s desmopressin was withdrawn, and he wasadministered hypertonic saline infusion. Within 24 hours hissymptoms had resolved and his serum sodium level hadincreased to 123 mEq/L. On the second day after admission,his serum sodium level had normalised.

The man’s desmopressin was recommenced at the usualdosage on the third day, and his continued to have a normalblood sodium level. At 1 month’s follow-up, his blood sodiumlevel was 141 mEq/L.

Author comment: "[W]e describe the case of a 46-year-oldman with central diabetes insipidus undergoing long-termtreatment with a constant dose of desmopressin whodeveloped acute severe symptomatic hyponatremia whendesmopressin was combined with [aceclofenac]".Bergoglio MT, et al. Acute severe hyponatremia induced by aceclofen in a malepatient with central diabetes insipidus. Endocrinologia y Nutricion 60: 338-340,No. 6, Jun 2013. Available from: URL: http://dx.doi.org/10.1016/j.endonu.2012.06.012 - Spain 803090269

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Reactions 20 Jul 2013 No. 14610114-9954/13/1461-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved