Korean J Med.  2014 Sep;87(3):323-327. 10.3904/kjm.2014.87.3.323.

A Case of Hyponatraemic Seizure Following Terlipressin Therapy for a Variceal Hemorrhage in a Patient with Liver Cirrhosis

• Kim JH
• Kim JK
• Mun SY
• Choi CJ
• Park HM
• Jeong YS
• Kang JG

• KMID: 2269243
• DOI: http://doi.org/10.3904/kjm.2014.87.3.323

Abstract

Terlipressin has splanchnic vasoconstrictive effects, and is generally used for the management of gastroesophageal variceal bleeding secondary to liver cirrhosis. Terlipressin is a synthetic arginine vasopressin (AVP) analog containing a nonapeptide sequence. Terlipressin has increased selectivity for the V1 receptor, compared with AVP; hence, it is considered to be a safe vasoconstrictor. However, side effects such as hyponatremia and seizure, although very rare, have been reported. Hyponatremia related to terlipressin may be caused by the syndrome of inappropriate antidiuresis (SIAD), which is a disorder of sodium and water balance characterized by hypotonic hyponatremia without elevation of the antidiuretic hormone level. Here, we report a case of hyponatremic seizure induced by an infusion of terlipressin in a 52-year-old female who had isolated gastric variceal bleeding secondary to alcoholic liver cirrhosis.

Keyword

Terlipressin; Hyponatremia; Seizure

MeSH Terms

Arginine Vasopressin
Esophageal and Gastric Varices
Female
Hemorrhage*
Humans
Hyponatremia
Liver Cirrhosis*
Liver Cirrhosis, Alcoholic
Middle Aged
Receptors, Vasopressin
Seizures*
Sodium
Arginine Vasopressin
Receptors, Vasopressin
Sodium