[Syndrome of inappropriate secretion of antidiuretic hormone and neurotoxicity induced by vincristine and alkylating agents during chemotherapy for malignant lymphoma of thyroid gland].
We report a syndrome of inappropriate secretion of antidiuretic hormone (SIADH), neurotoxicity and facial erythema induced by several anti-cancer drugs in a case of malignant lymphoma of thyroid gland. A 68-year-old male was admitted, complaining of neck tumor and dyspnea. On admission, he was treated with vincristine (VCR) for bronchostenosis due to malignant lymphoma. Neck tumor and mediastinal lymph node swelling reduced. On the ninth day after chemotherapy of VCR, a consciousness disturbance was found and he was diagnosed as having SIADH. Following chemotherapy of cyclophosphamide, SIADH was also induced so he was treated with irradiation for neck and mediastinal field, instead of chemotherapy. During irradiation, however, enlargement of systemic lymph nodes appeared, and the chemotherapy was resumed. He achieved partial remission, but somnolence after ifosfamide and facial erythema after ranimustine were observed. In spite of the difference in the chemical structure of these anti-cancer drugs, several side effects occurred. It is suggested that the direct effects of drugs on the nervous system were SIADH and neurotoxicity.
Tsujita
Y
Y
First Dept. of Internal Medicine, Osaka Medical College.
Iwao
N
N
Makino
S
S
Ohsawa
N
N
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects*; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D002490:Central Nervous System / Q000187:drug effects; D003520:Cyclophosphamide / Q000009:adverse effects; D004890:Erythema / Q000139:chemically induced; D006801:Humans; D007069:Ifosfamide / Q000009:adverse effects; D007177:Inappropriate ADH Syndrome / Q000139:chemically induced*; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000532:radiotherapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000532:radiotherapy; D008297:Male; D009607:Nitrosourea Compounds / Q000009:adverse effects; D013964:Thyroid Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D014750:Vincristine / Q000009:adverse effects*
D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D000972:Antineoplastic Agents, Phytogenic; D009607:Nitrosourea Compounds; D014750:Vincristine; D003520:Cyclophosphamide; C020766:ranimustine; D007069:Ifosfamide