1.
[Severe Hyponatremia after Cisplatin-Based Chemotherapy : Two Case Reports].
Ohtaka, M, Hattori, Y, Kumano, Y, Maeda, Y, Kondo, T, Mochizuki, T, Kawahara, T, Teranishi, J, Miyoshi, Y, Yumura, Y, et al
Hinyokika kiyo. Acta urologica Japonica. 2016;(7):361-6
Abstract
Hyponatremia is one of the common electrolyte disorders associated with cisplatin (CDDP) administration. We report here two cases of hyponatremia associated with CDDP. Case 1 : A 75-year-old man with urothelial carcinoma of bladder (cT3N1M0) underwent neoadjuvant chemotherapy with CDDP and gemcitabine. He lost consciousness on the eighth day after the chemotherapy. Blood tests showed severe hyponatremia (Na 113 mEq/l), low plasma osmolality and high level of plasma vasopressin. Urine tests showed low osmolality. These findings were consistent with the syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH). His consciousness level was improved after saline infusion and fluid restriction. Case 2 : A 54-year-old man with penile cancer (cT3N2M0) underwent neoadjuvant chemotherapy with CDDP, paclitaxel and fluorouracil. He lost consciousness on the seventh day after the chemotherapy. Blood tests showed hyponatremia(Na 121 mEq/l) with renal dysfunction. We concluded that the hyponatremia is due to the renal salt wasting syndrome (RSWS) based on renal dysfunction and high urinary sodium excretion. His consciousness level was improved after saline infusion. Although it is difficult to distinguish between SIADH and RSWS, correct evaluation is necessary for appropriate management of hyponatremia after CDDP administration.
2.
[Renal salt-wasting syndrome progressing to severe hyponatremia after chemotherapy--a case report].
Suzuki, H, Hirashima, T, Kobayashi, M, Sasada, S, Okamoto, N, Morishita, N, Tamiya, M, Matsui, K, Kusunoki, Y, Kawase, I
Gan to kagaku ryoho. Cancer & chemotherapy. 2010;(3):543-6
Abstract
A 66-year-old woman with small-cell lung cancer was administered chemo-radiotherapy consisting of cisplatin (CDDP) and etoposide (ETP). From day 3, she developed vomiting and hyponatremia that persisted despite fluid infusion and cortico-steroid administration. On day 7, the hyponatremia worsened (serum sodium level, 109 mEq/L), leading to disturbed consciousness and convulsions. The serum sodium level gradually increased after intravenous administration of hypertonic saline; on day 22, the serum sodium level was almost normal without any neurological implication. We diagnosed this clinical condition as renal salt-wasting syndrome (RSWS) on the basis of dehydration and high urinary sodium excretion at the onset. In the second course of chemotherapy, CDDP was replaced with carboplatin (CBDCA); consequently, hyponatremia was not observed. Hyponatremia that develops after the administration of CDDP may be due to not only the syndrome of inappropriate secretion of anti diuretic hormone (SIADH) but also RSWS. When RSWS is suspected, hypertonic saline should be administered.
3.
Prolonged clinical benefit from platinum-based chemotherapy in a patient with metastatic triple negative breast cancer.
Krockenberger, M, Engel, JB, Häusler, S, Dietl, J, Honig, A
European journal of gynaecological oncology. 2009;(4):449-51
Abstract
Triple negative breast cancer is a recently defined subgroup of tumors which do not express receptors for estrogen or progesterone and which do not show any overexpression of HER2 receptors. Tumors with these histopathologic features have an unfavorable prognosis and at present there is no standard chemotherapy regimen available. However, experimental studies and very recently some clinical data showed a benefit from platinum-based chemotherapy. We treated a 52-year-old caucasian female with metastatic triple negative breast cancer. She suffered from extensive liver disease resistant to taxane treatment and yttrium radiotherapy. Cisplatin/ifosfamide (12 cycles) induced regression of the liver metastasis from over 30 cm to 6 cm as revealed by CT scan. Dose-limiting toxicity was impairment of renal function and pancytopenia. The patient has now been stable for over ten months on a metronomic regimen of oral cyclophosphamide. This case report adds to recent evidence suggesting good clinical benefits of platinum-based regimens in early and advanced triple negative breast cancers.
4.
Sodium-wasting nephropathy caused by cisplatin in a patient with small-cell lung cancer.
Iyer, AV, Krasnow, SH, Dufour, DR, Arcenas, AS
Clinical lung cancer. 2003;(3):187-9
Abstract
We describe a case of severe hyponatremia following chemotherapy administration in a patient with small-cell lung cancer. There was no evidence of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion. The clinical and laboratory findings were consistent with a sodium-wasting nephropathy complicating cisplatin administration. There are few well-documented reports of cisplatin-associated hyponatremia in the medical literature. We have summarized the relevant literature and attempted to define the differential diagnosis of hyponatremia in this setting. Most cases are accounted for by sodium-losing nephropathy of SIADH, but many reported cases contain insufficient data for classification. Appropriate attention to the evaluation of hyponatremia following platinum-based chemotherapy is needed to properly treat these conditions.