Managing hyponatremia in lung cancer: latest evidence and clinical implications

Fiordoliva, Ilaria; Meletani, Tania; Baleani, Maria Giuditta; Rinaldi, Silvia; Savini, Agnese; Paolo, Marzia Di Pietro; Berardi, Rossana

doi:10.1177/1758834017736210

Cited by 39 publications

(43 citation statements)

References 63 publications

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“…Although patients with small cell lung cancer tended to have highest copeptin values compared to other cancer entities, copeptin values were not consistently elevated in this cancer subgroup and varied widely both in patient with cancer‐related and cancer‐unrelated SIAD. This can be explained by the fact that hyponatraemia in cancer patients may not only be caused by paraneoplastic AVP secretion, but by any other condition seen in noncancer patients: comorbidities, medication or symptoms as vomiting, nausea, dehydration or stress . Of note, irrespective of SIAD, copeptin is known to be elevated due to stress and acute conditions such a pneumonia, stroke or heart failure .…”

Section: The Role Of Copeptin In the Diagnosis Of Siadmentioning

confidence: 99%

Copeptin and its role in the diagnosis of diabetes insipidus and the syndrome of inappropriate antidiuresis

Refardt

Winzeler

2019

Clinical Endocrinology

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Clinical Endocrinology. 2019;91:22-32. wileyonlinelibrary.com/journal/cen 1 | INTRODUC TI ON Arginine vasopressin (AVP) is the main regulating hormone of body fluid homeostasis. It is secreted from the posterior pituitary upon osmotic or nonosmotic stimuli, with the main osmotic stimulus being increased plasma osmolality and the main nonosmotic stimulus being hypovolaemia and promotes water reabsorption via V2 receptors in the kidney, thereby normalizing hypertonicity and vasomotor tone. Disorders of body fluid homeostasis are common and can be divided into hyper-and hypoosmolar circumstances: the classical AbstractCopeptin is secreted in an equimolar amount to arginine vasopressin (AVP) but can easily be measured in plasma or serum with a sandwich immunoassay. The main stimuli for copeptin are similar to AVP, that is an increase in osmolality and a decrease in arterial blood volume and pressure. A high correlation between copeptin and AVP has been shown. Accordingly, copeptin mirrors the amount of AVP in the circulation.Copeptin has, therefore, been evaluated as diagnostic biomarker in vasopressin-dependent disorders of body fluid homeostasis. Disorders of body fluid homeostasis are common and can be divided into hyper-and hypoosmolar circumstances: the classical hyperosmolar disorder is diabetes insipidus, while the most common hypoosmolar disorder is the syndrome of inappropriate antidiuresis (SIAD). Copeptin measurement has led to a "revival" of the direct test in the differential diagnosis of diabetes insipidus. Baseline copeptin levels, without prior thirsting, unequivocally identify patients with nephrogenic diabetes insipidus. In contrast, for the difficult differentiation between central diabetes insipidus and primary polydipsia, a stimulated copeptin level of 4.9 pmol/L upon hypertonic saline infusion differentiates these two entities with a high diagnostic accuracy and is clearly superior to the classical water deprivation test. On the contrary, in the SIAD, copeptin measurement is of only little diagnostic value. Copeptin levels widely overlap in patients with hyponatraemia and emphasize the heterogeneity of the disease. Additionally, a variety of factors lead to unspecific copeptin elevations in the acute setting further complicating its interpretation. The broad use of copeptin as diagnostic marker in hyponatraemia and specifically to detect cancer-related disease in SIADH patients can, therefore, not be recommended. K E Y W O R D Scopeptin, diabetes insipidus, diagnosis, hypernatremia, hyponatraemia, primary polydipsia, SIAD This is an open access article under the terms of the Creat ive Commo ns Attri bution-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: The Role Of Copeptin In the Diagnosis Of Siadmentioning

confidence: 99%

Copeptin and its role in the diagnosis of diabetes insipidus and the syndrome of inappropriate antidiuresis

Refardt

Winzeler

2019

Clinical Endocrinology

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“…Hyponatremia may be related to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and this syndrome frequently occurs in several pulmonary conditions, such as small-cell lung cancer (15). Furthermore, hyponatremia is the most common electrolyte disorder in lung cancer patients and is a well-known prognostic and predictive factor (16). SARS-CoV2 infection may cause SIADH as this virus can target the central nervous system.…”

Section: Discussionmentioning

confidence: 99%

Biological Risk Factors Predict Transfer to Intensive Care Units and Death in Covid-19 Patients

Sauzay

Guyader

Evrard

et al. 2020

Preprint

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Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), causing the COVID-19, has been declared as pandemic by the World Health Organization. Epidemiological and clinical characteristics of patients with COVID-19 have been largely reported but biological risk factors have not yet been well described. In this retrospective and monocentric study, we explored 35 hematological and biochemical parameters, routinely measured at the Amiens University Hospital laboratory, between February 21, 2020 and March 30, 2020 for patients diagnosed with COVID-19. 154 patients were included in this study. We compared biological parameters collected at hospital admission between patients who survived or not after hospitalization. Non survivor patients displayed lower hemoglobin (p=0.02) and bicarbonate concentrations (p=0.03) and higher potassium concentration (p=0.03) compared to the survivors. We then compared these biological parameters between patients hospitalized in conventional care units and patients hospitalized in intensive care units (ICU). Numerous biological examinations had significant variations, including lymphocyte and neutrophil counts, bicarbonate, calcium and C Reactive Protein concentrations. In multivariate Cox analysis, risk factors for aggravation (defined as ICU admission or death) included low bicarbonate levels and hyponatremia. A significant worse overall survival was associated with hyponatremia, hyperkaliemia and prothrombin time > 16.8 seconds. We then proposed a prognostic score, to be validated in a future prospective study. Thus, these biological parameters, easily available, could help clinicians to identify high risk patients at an early stage of infection.

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“…Ayrıca, beyin, başboyun ve meme kanseri gibi tümörlerde de UADHS görülebilir (67) . Vinkristin, vinblastin ve sisplatin gibi sitotoksik ilaçlar farklı mekanizmalarla UADHS gelişimine neden olabilir (68,69) . Kanser hastalarında UADHS varlığı ile prognozu olumsuz etkilemektedir (71,72) .…”

Section: Tanıunclassified

Emergencies in Lung Cancer

Gümüş¹,

Özyurt²

2018

GGHS

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İnsanlarda beklenen ortalama yaşam süresinin artmasıyla birlikte kanser vakalarında da artışlar görülmektedir. Özellikle akciğer kanserinin görülme sıklığı ve mortalitesi dünya çapında artmaya devam etmektedir. Bu hastalarda sıklıkla akut ciddi semptomlar ve yaşamı tehdit eden durumlar ortaya çıkmakta ve acil tıbbi bakım gerekmektedir. Akciğer kanserinde acil servise başvuru ve mortalite diğer solit tümörlerden daha fazla görülmektedir. Bu acil durumlar kanserle direkt veya dolaylı olarak ya da tümörün tedavisi ile ortaya çıkar ve potansiyel olarak yaşamı tehdit eder. Tümörün bölgesel yayılımı ilişkili olarak vena kava süperior sendromu, perikardiyal tamponat, masif hemoptizi, massif plevral efüzyon ve akut hava yolu obstrüksiyonu görülmektedir. Hiperkalsemi, hiponatremi, uygunsuz ADH salınımı sendromu ve tümör lizis sendromu ise akciğer kanserinde ortaya çıkan metabolik acil durumlardır. Beyin metastazları, kemik metastazları ve spinal kord basısı uzak metastazlara bağlı olarak ortaya çıkmaktadır. Ayrıca, bu hastalarda kemoterapiye bağlı olarak febril nötropeni, hipersensitivite reaksiyonları ve anaflaksi, radyoterapiye bağlı olarak akut radyasyon pnömonitisi ve özefajit ortaya çıkmaktadır. Onkolojik aciller hayatı tehtit eder ve mortalitesi yüksektir. Mortalite ve morbiditeyi azaltmak için erken tanı ve tedavi büyük önem taşır. Çünkü tanı ve tedavide gecikmeler çoğu zaman ölümle sonuçlanabilmektedir.

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Managing hyponatremia in lung cancer: latest evidence and clinical implications

Cited by 39 publications

References 63 publications

Copeptin and its role in the diagnosis of diabetes insipidus and the syndrome of inappropriate antidiuresis

Copeptin and its role in the diagnosis of diabetes insipidus and the syndrome of inappropriate antidiuresis

Biological Risk Factors Predict Transfer to Intensive Care Units and Death in Covid-19 Patients

Emergencies in Lung Cancer

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