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Copeptin; Utility in paediatric patients with hyponatraemia

Lookup NU author(s): Dr Rachel Boal, Dr Deborah Matthews, Dr HC Johnstone, Professor Timothy Cheetham


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© 2021 S. Karger AG, Basel. All rights reserved. Introduction Copeptin concentrations are a useful component of the diagnostic work-up of paediatric patients with polyuria and polydipsia but the value of measuring copeptin in patients with hyponatraemia is less clear. Case Reports We report 5 children with hyponatraemia in the context of different underlying pathologies. Copeptin concentrations were elevated in 4 cases (13.7, 14.4, 26.1, 233pmol/L; reference range 2.4 - 8.6pmol/L) suggesting that non-osmoregulated vasopressin release (syndrome of inappropriate antidiuretic diuretic hormone or SIADH) was the underlying mechanism for the low sodium levels. In one of the patients there was an underlying diagnosis of Schaaf-Yang syndrome (MAGEL 2 gene mutation) with a clinical picture suggestive of dysregulated vasopressin production with inappropriately high and then low copeptin release. In one hyponatraemic patient, low copeptin concentrations indicated that non-osmoregulated AVP release was not the cause of hyponatraemia and oliguria. Discussion Copeptin measurement did not influence management acutely but helped to clarify the mechanism leading to hyponatraemia when the result was available. Relatively high and low copeptin concentrations in association with hypo and hypernatraemia indicates dysregulated vasopressin production in Schaaf-Yang syndrome. Profound copeptin elevation may be a clue to underlying sepsis.

Publication metadata

Author(s): Boal RL, Hughes J, Matthews D, Johnstone H, Boot C, Cheetham TD

Publication type: Article

Publication status: Published

Journal: Hormone Research in Paediatrics

Year: 2022

Volume: 95

Issue: 1

Pages: 82-87

Print publication date: 01/05/2022

Online publication date: 23/11/2021

Acceptance date: 18/11/2021

ISSN (print): 1663-2818

ISSN (electronic): 1663-2826

Publisher: S. Karger AG


DOI: 10.1159/000521073

PubMed id: 34814150


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