OXCARBAZEPINE RELATED HYPONATREMIA IN PEDIATRIC PATIENTS: BRAIN TUMORS ARE A RISK FACTOR
Abstract number :
1.255
Submission category :
Year :
2003
Submission ID :
1783
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Jennifer Disabato, Paul Levisohn, Pramote Laoprasert Division of Child Neurology, the Children[apos]s Hospital, University of Colorado Health Sciences Center, Denver, CO
While risk factors for oxcarbazepine (OXC) related hyponatremia (HN) have been determined for adult patients, risk factors for HN in children treated with OXC have not been defined. Two children with a prior history of brain tumors developed HN, defining some risk factors for OXC associated HN in children.
The charts of two patients treated at our institution who developed HN were reviewed.
Two patients, both males, developed clinically significant HN while receiving OXC for complex partial seizures. Both had developed brain tumors in the remote past but were free of active disease. Both were neurologically impaired as a result of the tumors and treatment. [table1]Both patients were mildly symptomatic with altered mental status. Patient 1 was treated with increased salt intake and has remained on OXC. His most recent serum Na+ was 137 mmol/l. OXC was discontinued in Patient 2 with his most recent Na+ also137 mmol/l.
HN occurs in approximately 2.5% of adults treated with OXC. Risk factors include older age and treatment with diuretics or other sodium wasting drugs. Most cases occur within 3-4 months of initiation of OXC. We have seen only 2 patients with OXC related HN. Common features include remote history of brain tumors and panhypopituitarism requiring supplementation. Of note is the relatively delayed onset of HN in one patient. In one patient, HN resolved without medication withdrawal. While uncommon, HN may occur in pediatric patients receiving OXC. Sequelae of CNS tumors appear to be a risk factor and such patients should be followed for possible development of HN.