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. Case Report: 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. Conclusion:
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.
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