Use of Tolvaptan in pediatric SIADH associated hyponatremia: A case report

Hyponatremia is a common electrolyte abnormality in pediatric patients, often associated with infections and central nervous system pathology. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a frequent cause. We describe the case of a 2-year-old girl with meningoencephalitis who developed symptomatic refractory hyponatremia. Despite conventional management, the patient continued to experience recurrent seizures associated with low sodium levels. We used fractional excretion of uric acid (FeUA) to diagnose SIADH and used Tolvaptan for management. FeUA can be utilized to diagnose SIADH and Tolvaptan may be considered a safe and effective treatment for SIADH-related hyponatremia in selected pediatric patients.