Department of Hepatobiliary Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
J Clin Pharm Ther. 2019 Dec;44(6):981-984. doi: 10.1111/jcpt.13031. Epub 2019 Aug 17.
Terlipressin has been shown to be effective in controlling variceal bleeding and decreasing associated mortality. Terlipressin is a synthetic analogue of vasopressin and is safer than arginine vasopressin; it induces selective vasoconstriction by stimulating the vasopressin V1 receptors that are predominantly located in the splanchnic tissues. However, severe hyponatraemia may occur during terlipressin treatment, resulting in neurological manifestations.
We describe two patients who presented a marked decrease in serum sodium levels and developed obvious neurological manifestations after receiving terlipressin therapy. Although the two patients were given sodium supplementation, their serum sodium levels continually declined. After the discontinuation of terlipressin, their serum sodium levels rapidly recovered to normal limits, and the neurological manifestations subsequently disappeared in both patients.
Some studies have reported hyponatraemia as a side effect of terlipressin; however, severe hyponatraemia with neurological manifestations has rarely been reported. We presented the cases of 2 patients with obvious neurological manifestations after receiving terlipressin therapy. Severe hyponatraemia may develop in patients treated with terlipressin, resulting in associated neurological symptoms. Therefore, the close monitoring of serum sodium is necessary.
特利加压素已被证明在控制静脉曲张出血和降低相关死亡率方面有效。特利加压素是一种血管加压素的合成类似物，比血管加压素安全；它通过刺激主要位于内脏组织中的血管加压素 V1 受体，诱导选择性血管收缩。然而，特利加压素治疗期间可能会发生严重的低钠血症，导致神经症状。
我们描述了两名患者在接受特利加压素治疗后出现血清钠水平显著下降并出现明显神经症状的情况。尽管两名患者都给予了钠补充，但他们的血清钠水平持续下降。停用特利加压素后，他们的血清钠水平迅速恢复正常，两名患者的神经症状随后消失。
一些研究报告了特利加压素的低钠血症作为副作用；然而，很少有报道严重的低钠血症伴有神经症状。我们报告了 2 例接受特利加压素治疗后出现明显神经症状的患者。接受特利加压素治疗的患者可能会发生严重的低钠血症，导致相关的神经症状。因此，有必要密切监测血清钠。
