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Case Reports in Anesthesiology
Volume 2017, Article ID 6467090, 3 pages
Case Report

Pitfalls in Interventional Pain Medicine: Hyponatremia after DDAVP for a Patient with Von Willebrand Disease Undergoing an Epidural Steroid Injection

1Department of Anesthesiology and Pain Medicine, University of Kansas Medical Center, Kansas City, KS, USA
2Division of Medical Oncology, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA

Correspondence should be addressed to Talal W. Khan; ude.cmuk@nahkt

Received 10 November 2016; Revised 27 February 2017; Accepted 9 March 2017; Published 14 March 2017

Academic Editor: Ilok Lee

Copyright © 2017 Talal W. Khan and Abdulraheem Yacoub. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Desmopressin (DDAVP), a synthetic analog of vasopressin, has been used in patients with von Willebrand disease (VWD), mild hemophilia A, and platelet dysfunction to reduce the risk of bleeding associated with surgical and interventional procedures. We report the case of a patient with VWD presenting with a bulging disc and radicular pain that underwent transforaminal epidural steroid injections. Her course was complicated with the interval development of headaches and dizziness symptomatic of moderate hyponatremia, likely due to excessive fluid intake. This report highlights a relatively rare side effect of DDAVP when used for prophylaxis in patients with VWD and reinforces the need for vigilance in these patients.