J Korean Gastric Cancer Assoc.  2006 Sep;6(3):198-201.

SIADH Caused by the Synergistic Effect of S-1 and Thiazide

• Ha TK
• Kwon SJ

Abstract

Hyponatremia is a dangerous electrolyte disturbance in patients on chemotherapy and may cause sudden death if not detected early. SIADH (syndrome of inappropriate antidiuretic hormone) is one of the known causes of hyponatremia in patients undergoing chemotherapy. Few chemotherapeutic agents, however, are reported to cause SIADH. The current study reports that SIADH developed in a 55 year old woman on S-1 (80 mg/m2) and cisplatin (60 mg/m2) chemotherapy for the peritoneal metastasis of gastric cancer. The patient underwent a total gastrectomy, a splenectomy, and a segmental resection of the transverse colon for gastric cancer. She had used thiazide and betablocker to treat hypertension for 12 years. She admitted to our hospital with complaining of general weakness, dysarthria, loss of appetite, and urinary discomfort. The serum level of sodium and potassium were 94 mEq/L and 2.2 mEq/L respectively. The hyponatremia completely resolved uneventfully after 3% saline infusion, which led to normalized electrolyte balance. The patient was discharged on the 13th hospital day.

Keyword

SIADH; Chemotherapy; S-1; Thiazide; Gastric cancer

MeSH Terms

Appetite
Cisplatin
Colon, Transverse
Death, Sudden
Drug Therapy
Dysarthria
Female
Gastrectomy
Humans
Hypertension
Hyponatremia
Inappropriate ADH Syndrome*
Middle Aged
Neoplasm Metastasis
Potassium
Sodium
Splenectomy
Stomach Neoplasms
Water-Electrolyte Balance
Cisplatin
Potassium
Sodium