Desmopressin before colonoscopy can lead to hyponatremia: BMC Case Report

A new case study published in BMC Nephrology suggests Clinicians be aware that the use of desmopressin, a significant risk factor for hyponatremia in addition to the use of a few well-known drugs and the presence of comorbidities.

Preparing the bowel for a colonoscopy is often regarded as a safe procedure. During bowel preparation, hyponatremia is a problem that has been documented in the literature. The majority of people who experience severe symptoms of hyponatremia are elderly and have other medical conditions including chronic kidney disease, hypothyroidism, or adrenal insufficiency. This potentially lethal complication, nevertheless, can also result from other processes and situations.

This case report by Ting-Hsuan Chiang and colleagues demonstrates a rare occurrence of a patient who experienced an acute hyponatremia-related seizure prior to a colonoscopy without experiencing any well-known risk factors. The usage of desmopressin was thought to have led to this significant consequence, which was later diagnosed as water intoxication.

A colonoscopy was scheduled for a 72-year-old man after a colonic lesion was identified accidentally during a regular health check two months before. The patient was aware, oriented, and denied any discomfort during the morning visit on the day of the colonoscopy. However, during anesthetic evaluation before the surgery, he was discovered to be sluggish and confused. The patient experienced a tonic-clonic seizure that lasted roughly one minute. He was sent to the critical care unit for additional assessment after a quick intubation.