Tuberc Respir Dis.  2009 Apr;66(4):324-328.

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

• Lee KJ
• Moon JY
• Lee SY
• Lee SY
• Kim JH
• Shin C
• Shim JJ
• In KH
• Kang KH
• Yoo SH

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.

Keyword

Inappropriate ADH syndrome; Non-small-cell lung carcinoma; Hyponatremia; Carboplatin

MeSH Terms

Carboplatin
Carcinoma, Non-Small-Cell Lung
Central Nervous System
Central Nervous System Diseases
Cisplatin
Cyclophosphamide
Deoxycytidine
Humans
Hyponatremia
Inappropriate ADH Syndrome
Lung
Lung Neoplasms
Osmolar Concentration
Plasma
Vincristine
Carboplatin
Cisplatin
Cyclophosphamide
Deoxycytidine
Vincristine

Figure

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  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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