内容紹介
Onset of Syndrome of Inappropriate Secretion of Antidiuretic Hormone in a Gastric Cancer Patient on SOX Treatment
Summary
A 78-year-old man with advanced gastric cancer was treated with S-1 and oxaliplatin chemotherapy. He developed hiccups and nausea, and was diagnosed with hyponatremia(serum Na: 120 mEq/L)on day 6 of the first treatment course. Because of his increased urinary Na excretion and relatively high ADH values, he was subsequently diagnosed with chemotherapy-induced syndrome of inappropriate secretion of antidiuretic hormone. The patient recovered after an infusion of hypertonic saline. Although S-1 was restarted, hyponatremia did not recur. We suspected adverse drug reactions to ACE inhibitors and K-sparing diuretics in our case of hyponatremia.
要旨
症例は78歳,男性。進行胃癌に対しS-1とオキサリプラチンによる化学療法を行った。初回,吃逆と吐気が出現し,6日目に低Na血症(血清Na 120 mEq/L)が判明した。尿中Naの排泄増加およびADHの相対的高値から,化学療法による抗利尿ホルモン分泌不適合症候群と診断した。高張食塩水点滴で回復した。S-1を再開したが低Na血症の再現はみなかった。自験例の低Na血症には内服していたACE阻害薬とK保持性利尿薬の関与も疑われた。
目次
Summary
A 78-year-old man with advanced gastric cancer was treated with S-1 and oxaliplatin chemotherapy. He developed hiccups and nausea, and was diagnosed with hyponatremia(serum Na: 120 mEq/L)on day 6 of the first treatment course. Because of his increased urinary Na excretion and relatively high ADH values, he was subsequently diagnosed with chemotherapy-induced syndrome of inappropriate secretion of antidiuretic hormone. The patient recovered after an infusion of hypertonic saline. Although S-1 was restarted, hyponatremia did not recur. We suspected adverse drug reactions to ACE inhibitors and K-sparing diuretics in our case of hyponatremia.
要旨
症例は78歳,男性。進行胃癌に対しS-1とオキサリプラチンによる化学療法を行った。初回,吃逆と吐気が出現し,6日目に低Na血症(血清Na 120 mEq/L)が判明した。尿中Naの排泄増加およびADHの相対的高値から,化学療法による抗利尿ホルモン分泌不適合症候群と診断した。高張食塩水点滴で回復した。S-1を再開したが低Na血症の再現はみなかった。自験例の低Na血症には内服していたACE阻害薬とK保持性利尿薬の関与も疑われた。