title: [Severe hyponatremia with consciousness disturbance caused by hydroxyurea in a patient with chronic myeloid leukemia].
abstract: A 79-year-old man was admitted because of consciousness disturbance on August 9, 2002. He had been diagnosed as having chronic myeloid leukemia in 1999, and since then, he had continued to take hydroxyurea (1500 mg/day) orally. On admission, his serum sodium concentration was as low as 119 mEq/L, while urinary sodium excretion was high. Based on the blood picture and lack of hepatosplenomegaly, we considered that the leukemia was still in the chronic phase. Because of normal blood level of the antidiuretic hormone (ADH) concentration and sufficient urine volume, the syndrome of inappropriate ADH secretion (SIADH) was unlikely, and sodium-losing nephropathy was suspected. After discontinuation of hydroxyurea, the urinary sodium excretion decreased and the patient's consciousness became clear concomitantly with improvement in the serum Na level. This patient appears to be the first case of hyponatremia caused by hydroxyurea.
authors.affiliation: Department of Hematology and Clinical Immunology, Kobe City General Hospital.
authors.forename: Naoko
authors.initials: N
authors.lastname: Watanabe
authors.forename: Minako
authors.initials: M
authors.lastname: Tani
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kurata
authors.forename: Akiko
authors.initials: A
authors.lastname: Matsushita
authors.forename: Akinori
authors.initials: A
authors.lastname: Maeda
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nagai
authors.forename: Takayuki
authors.initials: T
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003244:Consciousness Disorders / Q000139:chemically induced*; D006801:Humans; D006918:Hydroxyurea / Q000009:adverse effects*; D007010:Hyponatremia / Q000139:chemically induced*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008297:Male; D012720:Severity of Illness Index
chemical_list: D000970:Antineoplastic Agents; D006918:Hydroxyurea