Efficiency of Single Dose of Tolvaptan Treatment During the Triphasic Episode After Surgery for Craniopharyngioma

Gürbüz, Fatih; Taştan, Mehmet; Turan, İhsan; Yüksel, Bilgin

doi:10.4274/jcrpe.galenos.2018.2018.0182

Cited by 10 publications

(4 citation statements)

References 20 publications

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“…It is safe to correct hyponatremia by 6–8 mmol/L per day. However, the rapid correction of hyponatremia can be life‐threatening and leads to osmotic demyelination syndrome (Gürbüz et al., 2019 ). For patients with CSW, immediate fluid resuscitation is recommended to restore blood volume and increase serum Na + levels.…”

Section: Discussionmentioning

confidence: 99%

Serum sodium level fluctuations following the resection of childhood‐onset craniopharyngioma

Miao,

Fan,

Peng

et al. 2024

Brain and Behavior

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BackgroundCraniopharyngiomas are low‐grade malignancies (WHO I) in the sellar region. Most cases of childhood‐onset craniopharyngioma are adamantinomatous craniopharyngioma, and neurosurgery is the treatment of choice. Affected patients have postoperative complications, including water and electrolyte disturbances, because these malignancies develop near the hypothalamus and pituitary gland. Determining postoperative serum sodium fluctuation patterns in these patients can reduce postoperative mortality and improve prognosis.ObjectiveTo measure changes in serum sodium levels in pediatric patients who underwent craniopharyngioma surgery and identify influencing factors.MethodsThis retrospective study measured the serum sodium levels of 202 patients aged 0–18 years who underwent craniopharyngioma resection in Beijing Tiantan Hospital and Beijing Children's Hospital and identified predictors of severe hyponatremia and hypernatremia.ResultsThe mean age of the cohort was 8.35 ± 4.35 years. The prevalence of hypernatremia, hyponatremia, and their severe forms (serum Na+ > 150 mmol/L and serum Na+ < 130 mmol/L) within 14 days after surgery was 66.3%, 72.8%, 37.1%, and 40.6%, respectively. The mean postoperative serum sodium level showed a triphasic pattern, characterized by two peaks separated by a nadir. Sodium levels peaked on days 2 (143.6 ± 7.6 mmol/L) and 14 (143.2 ± 6.7 mmol/L) and reached their lowest on day 6 (135.5 ± 7.5 mmol/L). A total of 31 (15.3%) patients met the diagnostic threshold for hyponatremia and hypernatremia of the triphase response, whereas 116 (57.4%) patients presented this pattern, regardless of met the diagnostic criteria or not. The prevalence of severe hyponatremia varied depending on preoperative endocrine hormone deficiency, tumor status (primary or recurrent), and surgical approach.ConclusionsSerum sodium levels after craniopharyngioma resection in children showed a triphasic pattern in most cases. The risk of postoperative hyponatremia varied depending on preoperative endocrine hormone deficiency, tumor status (primary or recurrent), and surgical approach.

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Section: Discussionmentioning

confidence: 99%

Serum sodium level fluctuations following the resection of childhood‐onset craniopharyngioma

Miao,

Fan,

Peng

et al. 2024

Brain and Behavior

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“…Reports of tolvaptan use for SIADH in children are limited [ 6 , 7 , 8 , 9 , 10 , 11 ]. The reported pediatric patients are summarized in Table 2 .…”

Section: Discussionmentioning

confidence: 99%

Regulation of Serum Sodium Levels during Chemotherapy Using Selective Arginine Vasopressin V2-Receptor Antagonist Tolvaptan in a Four-Year-Old Girl with a Suprasellar Germ Cell Tumor

et al. 2021

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There are limited reports on the use of tolvaptan for syndrome of inappropriate antidiuretic hormone secretion (SIADH) in children. Managing serum sodium levels in SIADH patients during chemotherapy is often difficult because of the need for massive fluid infusions. We report the course of the use of tolvaptan for the treatment of hyponatremia during chemotherapy in a four-year-old girl with a suprasellar germ cell tumor. The patient was a Japanese girl who presented with left ptosis with a mass in the pituitary gland and cavernous sinus. She was diagnosed with an intermediate-grade germ cell tumor and was treated with carboplatin and etoposide combination chemotherapy. She developed hyponatremia due to SIADH caused by intravenous infusion therapy before chemotherapy. Subsequently, tolvaptan (3.25 mg; 0.20 mg/kg/dose) was administered orally to control serum sodium levels. After 4 h of administration, a marked increase in urine volume of up to 15 mL/kg/h was observed, and serum sodium level increased from 126 to 138 mEq/L after 10 h of tolvaptan administration, followed by a decrease in urine volume. The use of tolvaptan in pediatric patients with SIADH who require intravenous hydration during chemotherapy can be useful for the management of serum sodium balance.

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“…Excessive correction of hyponatremia was observed in 23% of patients, all these patients having baseline serum Na <125 mmol/L, but no cases of ODS were recorded [31]. Even a single dose of tolvaptan can be sufficient to correct hyponatremia in some children [32]. Tolvaptan recently has been implicated in causing serum aminotransferase elevation as well as clinically apparent acute liver injury by idiosyncrasy.…”

Section: Early Postoperative Fluid-electrolyte Disturbancesmentioning

confidence: 99%

Postoperative and Long-Term Endocrinologic Complications of Craniopharyngioma

Bereket¹

2020

Horm Res Paediatr

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Background: Craniopharyngioma (CP), despite being a malformational tumor of low histological grade, causes considerable morbidity and mortality mostly due to hypothalamo-pituitary dysfunction that is created by tumor itself or its treatment. Summary: Fluid-electrolyte disturbances which range from dehydration to fluid overload and from hypernatremia to hyponatremia are frequently encountered during the acute postoperative period and should be carefully managed to avoid permanent neurological sequelae. Hypopituitarism, increased cardiovascular risk, hypothalamic damage, hypothalamic obesity, visual and neurological deficits, and impaired bone health and cognitive function are the morbidities affecting the well-being of these patients in the long term. Key Messages: Timely and optimal treatment of early postoperative and long-term complications of CP is crucial for preserving quality of life of these patients.

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Efficiency of Single Dose of Tolvaptan Treatment During the Triphasic Episode After Surgery for Craniopharyngioma

Cited by 10 publications

References 20 publications

Serum sodium level fluctuations following the resection of childhood‐onset craniopharyngioma

Serum sodium level fluctuations following the resection of childhood‐onset craniopharyngioma

Regulation of Serum Sodium Levels during Chemotherapy Using Selective Arginine Vasopressin V2-Receptor Antagonist Tolvaptan in a Four-Year-Old Girl with a Suprasellar Germ Cell Tumor

Postoperative and Long-Term Endocrinologic Complications of Craniopharyngioma

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