Efficacy of COX-2 inhibitors in a case of congenital nephrogenic diabetes insipidus


SOYLU A., Kasap B., Ogun N., Ozturk Y., Turkmen M., Hoefsloot L., ...More

PEDIATRIC NEPHROLOGY, vol.20, no.12, pp.1814-1817, 2005 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 20 Issue: 12
  • Publication Date: 2005
  • Doi Number: 10.1007/s00467-005-2057-8
  • Journal Name: PEDIATRIC NEPHROLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.1814-1817
  • Keywords: amiloride, cyclooxygenase-2 inhibitors, hydrochlorothiazide, nephrogenic diabetes insipidus, PROSTAGLANDIN SYNTHESIS, HYDROCHLOROTHIAZIDE, AQUAPORIN-2, VASOPRESSIN, INDOMETHACIN, RAT, FAMILIES, WATER
  • Dokuz Eylül University Affiliated: Yes

Abstract

A 17-month-old boy presented with failure to thrive, polyuria, and vomiting. He had been diagnosed clinically with nephrogenic diabetes insipidus and treated by amiloride and hydrochlorothiazide combination without a satisfactory outcome at another center since 1 year of age. The diagnosis was confirmed by genetic analysis (AVPR2mutation), and the treatment was modified to include rofecoxib (a selective cyclooxygenase-2 inhibitor) in addition to hydrochlorothiazide and amiloride. This combination along with a low-salt diet resulted in a dramatic decrease in urinary free-water loss, while no side effect was noted. Because of prohibition of rofecoxib, it had to be substituted first by indomethacin and then by ibuprofen. However, both drugs were ineffective in controlling water diuresis. Thus, we had to replace these drugs by celecoxib (another selective cyclooxygenase-2 inhibitor). We conclude that the combination hydrochlorothiazide/amiloride/cyclooxygenase-2 inhibitor could be successfully used to treat congenital nephrogenic diabetes insipidus.