Journal List > Tuberc Respir Dis > v.66(4) > 1001367

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

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.

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.
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Table 1
Laboratory data on the time of diagnosis and five days after carboplatin and gemcitabine chemotherapy
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