Water intoxication following low-dose intravenous cyclophosphamide.
Cyclophosphamide is frequently used for the treatment of severe lupus nephritis, but is very rarely associated with dilutional hyponatremia. Recently we experienced a case of water intoxication following low-dose intravenous cyclophosphamide. Five hours after one dose of intravenous pulse cyclophosphamide 750 mg, the patient developed nausea, vomiting, and general weakness. Serum sodium concentration revealed 114 mEq/L and her hyponatremia was initially treated with hypertonic saline infusion. Then her serum sodium concentration rapidly recovered to normal with water restriction alone. During the course of intravenous pulse cyclophosphamide therapy, one must be aware of the possibility of significant water retention.
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Tai Yeon
TY
Koo
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Sang-Cheol
SC
Bae
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Joon Sung
JS
Park
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Chang Hwa
CH
Lee
Department of Pathology, Hanyang University College of Medicine, Seoul, Korea.
Moon Hyang
MH
Park
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Chong Myung
CM
Kang
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Gheun-Ho
GH
Kim
Cyclophosphamide; Hyponatremia; Lupus nephritis; Water intoxication