Severe hyponatremia in a patient with mantle cell lymphoma treated with bortezomib: a case report and review of the literature.
BACKGROUND
Hyponatremia is a known complication of cytotoxic treatment. We observed this side effect in a patient treated with bortezomib. This paper gives an overview of the literature on antineoplastic agents that have been associated with hyponatremia.


METHODS
A 77-year-old female patient with mantle cell lymphoma was admitted with rapidly progressive ataxia, slurred speech, and confusion. 43 days earlier, a second-line treatment with the proteasome inhibitor bortezomib had been started. Neurological examination revealed no focal deficits. Laboratory evaluation showed a combined electrolyte disorder with severe hyponatremia (sodium 112 mmol/l).


RESULTS
A syndrome of inappropriate secretion of antidiuretic hormone (SIADH) was diagnosed, and bortezomib was identified as its cause. The drug was consecutively stopped. CT scan showed a complete remission (CR). Since, the patient has remained in a CR without further tumor-specific treatment.


CONCLUSIONS
Hyponatremia may be a side effect of treatment with bortezomib and a number of other antineoplastic agents. Because of limited data available, accurate incidences of this complication are not known.
Abteilung Onkologie/Hämatologie, Departement Innere Medizin, Kantonsspital Graubünden, Chur, Switzerland.
Stefan
S
Brodmann
Evelyne
E
Gyr Klaas
Richard
R
Cathomas
Vincenzo
V
Girardi
Roger
R
von Moos
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001897:Boronic Acids / Q000009:adverse effects* / Q000627:therapeutic use*; D000069286:Bortezomib; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced* / Q000175:diagnosis* / Q000517:prevention & control; D020522:Lymphoma, Mantle-Cell / Q000150:complications / Q000188:drug therapy*; D011719:Pyrazines / Q000009:adverse effects* / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib