title: [Severe Hyponatremia after Cisplatin-Based Chemotherapy : Two Case Reports].
abstract: Hyponatremia is one of the common electrolyte disorders associated with cisplatin (CDDP) administration. We report here two cases of hyponatremia associated with CDDP. Case 1 : A 75-year-old man with urothelial carcinoma of bladder (cT3N1M0) underwent neoadjuvant chemotherapy with CDDP and gemcitabine. He lost consciousness on the eighth day after the chemotherapy. Blood tests showed severe hyponatremia (Na 113 mEq/l), low plasma osmolality and high level of plasma vasopressin. Urine tests showed low osmolality. These findings were consistent with the syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH). His consciousness level was improved after saline infusion and fluid restriction. Case 2 : A 54-year-old man with penile cancer (cT3N2M0) underwent neoadjuvant chemotherapy with CDDP, paclitaxel and fluorouracil. He lost consciousness on the seventh day after the chemotherapy. Blood tests showed hyponatremia(Na 121 mEq/l) with renal dysfunction. We concluded that the hyponatremia is due to the renal salt wasting syndrome (RSWS) based on renal dysfunction and high urinary sodium excretion. His consciousness level was improved after saline infusion. Although it is difficult to distinguish between SIADH and RSWS, correct evaluation is necessary for appropriate management of hyponatremia after CDDP administration.
authors: The Departments of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors: Mari
authors: M
authors: Ohtaka
authors: The Departments of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors: Yusuke
authors: Y
authors: Hattori
authors: The Departments of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors: Yohei
authors: Y
authors: Kumano
authors: The Departments of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors: Yoko
authors: Y
authors: Maeda
authors: The Departments of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors: Takuya
authors: T
authors: Kondo
authors: The Departments of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors: Taku
authors: T
authors: Mochizuki
authors: The Departments of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors: Takashi
authors: T
authors: Kawahara
authors: The Departments of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors: Jun-Ichi
authors: J
authors: Teranishi
authors: The Departments of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors: Yasuhide
authors: Y
authors: Miyoshi
authors: The Departments of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors: Yasushi
authors: Y
authors: Yumura
authors: The Departments of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors: Hiroji
authors: H
authors: Uemura
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects*; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced* / Q000628:therapy; D007177:Inappropriate ADH Syndrome / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D012720:Severity of Illness Index; D012965:Sodium Chloride / Q000008:administration & dosage
chemical_list: D000970:Antineoplastic Agents; D012965:Sodium Chloride; D002945:Cisplatin