METHODS: A 2414-g female infant was born at 38 wk by normal vaginal delivery. Facial anomalies and head magnetic resonance imaging indicated semilobar HPE. After birth, she had hyponatremia due to SIADH and was treated using water and sodium restriction. However, she developed an exaggerated response to the fluid restrictions, resulting in large fluctuations in serum sodium levels. Subsequent administration of tolvaptan improved the fluctuations in serum sodium levels without the need for adjustment of water or sodium administration. Serum sodium was maintained within the normal range after discontinuation of tolvaptan at 80 d of life. There were no side effects, such as hypernatremia or liver dysfunction, during the administration of tolvaptan.
CONCLUSIONS: This is the first report on the safety and efficacy of tolvaptan in an infant with SIADH associated with HPE.
方法:一名2414-g女婴在38周通过正常阴道分娩出生。面部异常和头部磁共振成像提示半叶HPE。出生后,她患有SIADH引起的低钠血症,并接受了限水限钠治疗.然而,她对液体限制做出了夸张的反应,导致血清钠水平的大幅波动。随后施用托伐普坦改善了血清钠水平的波动,而无需调整水或钠的施用。生命80d停用托伐普坦后,血清钠维持在正常范围内。没有副作用,如高钠血症或肝功能障碍,在服用托伐普坦期间。
结论:这是关于托伐普坦在SIADH与HPE相关的婴儿中的安全性和有效性的第一份报告。