Carboplatin/cisplatin

Abstract

S Carboplatin/cisplatin Hyponatraemia due to SIADH: case reportA 68-year-old man with small-cell lung carcinoma developed hyponatraemia due to syndrome of inappropriate anti-diuretic hormone (SIADH) during treatment with cisplatin and then experienced a recurrence during treatment with carboplatin [dosages and routes of administration not stated].The man, who was a smoker, started receiving cisplatin with hydration; his sodium level was 138 mmol/L. On the evening of day 1, he was re-admitted with sudden-onset seizures and coma. He had a blood sodium level of 107 mmol/L, a plasma osmolality of 224 mOsm/kg water, a serum uric acid level of 212 µmol/L; his natriuresis was > 20 mmol/L.The man received treatment including demeclocycline and diuretics with rapid correction of his sodium level and his neurologically symptoms resolved. Cisplatin was replaced by carboplatin at a 75% dose for his second course of chemotherapy; his sodium level was 138 mmol/L. On day 2, he presented with severe hyponatraemia (115 mmol/L) and confusion. His condition resolved. Prior to his third course of chemotherapy, his sodium level was 138 mmol/L. He received carboplatin and developed hyponatraemia again (119 mmol/L) without neurological symptoms. His condition quickly resolved.Author comment: In our case, the patient presented with severe hyponatraemia after each course of chemotherapy. At the time of the first episode of hyponatraemia (day 1 of the first course), his blood sodium level was 107 mmol/L, his calculated plasma osmolality was 224 mOsm/kg of water, and his natriuresis was greater than 20 mmol/L. These results correspond with the criteria for SIADH.