Resumen de Tratamiento con desmopresina oral en un neonato con diabetes insípida
Mª Pilar Ortega García, G. Carmona Ibáñez, Eduardo López Briz, F. I. Torres Bondia, J. Guevara Serrano
We present the case of a girl with a bilateral harelip with a complete palatine fissure and diagnosed 21 days after her birth with central insipidus diabetes. After several days of subcutaneous treatment with desmopressin, we decided to treat her orally, because the intranasal pathway was not viable due to that her malformative syndrome and the subcutaneous treatment impeded her discharge for not being guaranteed the treatment continuation at home. After consulting the bibliography (Medline, Micromedex) and check out the oral bioavailability of desmopressin, we elaborated a solution firm Minurin® nasal drops and physiological serum up to a concentration of 3.33 mcg/mL, being able to guaranteeing her stability for a minimum period of a month. We initiated the treatment with the recommended dosage by the bibliography and, we were adjusting them based on the concentration of plasmatic ions and the diuresis. In this way, we were able to maintain the normalization of these ones achieved with the subcutaneous administration, as well as a continuation in the observed ponderal increase since the beginning of the treatment with desmopressin. It was necessary to solicit its compassive use, because in Spain it is not authorized the oral use of desmopressin. From this study, we can conclude that the oral administration of desmopressin is an effective alternative in the treatment of the central insipidus diabetes in circumstances that impede the use of the intranasal pathway
