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Lee, Moon, Lee, Lee, Kim, Shin, Shim, In, Kang, and Yoo: A Case of Syndrome of Inappropriate Secretion of Antidiuretic Hormone Following Chemotherapy in a Patient with Non-Small-Cell Lung Cancer
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Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 66(4): 324-328.

Published online: 30 April 2009

DOI: https://doi.org/10.4046/trd.2009.66.4.324

A Case of Syndrome of Inappropriate Secretion of Antidiuretic Hormone Following Chemotherapy in a Patient with Non-Small-Cell Lung Cancer

Kyoung Ju Lee, M.D., Jae Young Moon, M.D., Sung Yong Lee, M.D., Sang Yeub Lee, M.D., Je Hyeong Kim, M.D., Chol Shin, M.D., Jae Jeong Shim, M.D., Kwang Ho In, M.D., Kyung Ho Kang, M.D., Se Hwa Yoo, M.D.

Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

Address for correspondence: Kyung Ho Kang, M.D. Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 97, Guro-dong, Guro-gu, Seoul 152-703, Korea. Phone: 82-2-2626-3028, Fax: 82-2-865-9670, kkhchest@kumc.ac.kr

Received 24 February 2009       Accepted 10 April 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

The syndrome of inappropriate secretion of the antidiuretic hormone (SIADH) is a well recognized paraneoplastic phenomenon related to impaired water excretion, and can result in dilutional hyponatremia as well as central nervous system symptoms. It is characterized by a decrease in plasma osmolarity with inappropriately concentrated urine. The causes of SIADH are associated with pulmonary and endocrine disorders, central nervous system diseases, and malignancies, including lung cancer. The other causes of SIADH include some drugs, particularly chemotherapy agents. Anticancer drugs, such as cisplatin, vincristine, and cyclophosphamide are well known causes of SIADH but the mechanisms are unclear. Recently, we encountered a patient with advanced non-small cell lung cancer who suffered from general weakness and altered mentality after an intravenous carboplatin and gemcitabine combination.

Keywords: Inappropriate ADH syndrome, Non-small-cell lung carcinoma, Hyponatremia, Carboplatin

Figures and Tables

Figure 1
(A) At the day of diagnosis, chest X-ray showed inactive pulmonary tuberculosis on the right upper lobe (RUL) and emphysema on both lung, a malignant mass with atelectasis in the left lower lobe (LLL) and pleural effusion in the left hemithorax. (B) When the patient was hospitalized for generalized weakness and confused mentality, there was no remarkable interval change as compared with the previous film.
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Figure 2
(A, B) Chest CT showed that the primary mass noted in the left hilum with complete occlusion of LLL bronchus and direct infiltration into the mediastinum, conglomerated lymph node enlargement in the left hilum, pleural effusion in the left hemithorax adjacent area of LLL mass and enlarged left adrenal gland.
trd-66-324-g002
Table 1
Laboratory data on the time of diagnosis and five days after carboplatin and gemcitabine chemotherapy
trd-66-324-i001

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