This study shows that higher AMS scores are associated with lower SF-12 indices and suggests that elevated values of the AMS score are associated with cardiovascular risk factors or diseases.

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.

The large interindividual variability of utility values precludes a prediction about the acceptance of a new therapeutic regimen by an individual patient. The assessment of the utility enables, however, a more objective judgment of the general acceptance of any possible risk/benefit ratio induced by a new immunosuppressive regimen in our patient population.

We describe a rare case of stroke after intravenous immunoglobulin (IVIg) administration and the first case of its occurrence in Evans’ syndrome. Our patient, a 42-year-old man, was admitted with increasing fatigue and generalised lymphadenopathy. He presented with a severe autoimmune haemolytic anaemia, and an angioimmunoblastic T-cell lymphoma was histologically diagnosed. Despite initiation of a combination chemotherapy regimen comprising cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP), an immune thrombocytopenia additionally developed, indicating an Evans’ syndrome. In order to control the autoimmune process more rapidly we infused IVIg. Within 12 h the patient developed sensomotoric central nervous symptoms. An nuclear magnetic resonance angiography revealed an ischaemic stroke in the right middle cerebral artery. Within few days the patient partially recovered from his neurological deficits. This serious side-effect supports the strategy of limiting IVIg therapy to clinical situations only where it is clearly justified.