[Renal salt-wasting syndrome progressing to severe hyponatremia after chemotherapy--a case report]

Gan To Kagaku Ryoho. 2010 Mar;37(3):543-6.
[Article in Japanese]

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.

Publication types

  • Case Reports
  • English Abstract
  • Review

MeSH terms

  • Aged
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Cisplatin / adverse effects*
  • Etoposide / adverse effects
  • Female
  • Humans
  • Hyponatremia / chemically induced*
  • Kidney Diseases / chemically induced*
  • Lung Neoplasms / drug therapy
  • Small Cell Lung Carcinoma / drug therapy
  • Syndrome

Substances

  • Antineoplastic Agents
  • Etoposide
  • Cisplatin