Syndrome of inappropriate antidiuretic hormone secretion as a side effect of chemotherapy for testicular cancer: A case report

Abstract

Introduction Inappropriate antidiuretic hormone secretion syndrome can be a serious adverse event of cisplatin‐based chemotherapy. Cisplatin had to be changed to other drugs or chemotherapy completely discontinued in earlier reported cases. Case presentation Three cycles of bleomycin, etoposide, and cisplatin chemotherapy were planned for a 40‐year‐old man with a diagnosis of lymph node recurrence of testicular cancer. On day 9, he suffered from vomiting and mental disturbance. Severe hyponatremia (110 mEq/L) with low plasma osmolality led to a diagnosis of a syndrome of inappropriate antidiuretic hormone secretion, and infusions of hypertonic saline and salt intake were prescribed. Second and third courses of bleomycin, etoposide, and cisplatin chemotherapy could then be given with careful electrolyte management. Conclusion Continuation of cisplatin administration with precise electrolyte adjustment can be a treatment option in regimens where cisplatin is essential for achieving optimal antitumor efficacy.

Elderly with refractory chronic severe hyponatremia and anesthesia management dilemma: a case report with literature review

“…Malignancy can be associated with hyponatremia due to poor diet, adrenal dysfunction, renal or cerebral salt wasting, and SIADH via ectopic arginine vasopressin (AVP) production or chemotherapy-induced AVP stimulation. 10 Further, paraneoplastic syndrome is a crucial aspect to consider. The tumors most commonly resulting in hyponatremia of the SIADH type are lung, breast, and head and neck tumors.…”

Editorial Comment to Syndrome of inappropriate antidiuretic hormone secretion as a side effect of chemotherapy for testicular cancer: A case report

“…3 In previously reported cases of cisplatin-related SIADH, cisplatin has been replaced with another drug or chemotherapy has been discontinued; Maeda et al, however, continued to administer BEP chemotherapy and successfully treated this patient. 3 They demonstrated that the threat of SIADH as a severe adverse event can be overcome through the careful monitoring of sodium levels and appropriate mineral recruitment. 3 I would like to send a message to readers as well as to the authors.…”

“…3 They demonstrated that the threat of SIADH as a severe adverse event can be overcome through the careful monitoring of sodium levels and appropriate mineral recruitment. 3 I would like to send a message to readers as well as to the authors. Although the BEP regimen is the gold standard for induction chemotherapy in patients with metastatic GCC, we need not persist with the BEP regimen when complications arise.…”

“…In fact, Maeda et al noted that the patient in their present report could not safely receive bleomycin on day 15 in the first BEP cycle because of a severe adverse event. 3 Skipping scheduled doses in this way reduces the relative dose intensity: removing the bleomycin from the BEP regimen makes it comparable to the etoposide/cisplatin (EP) regimen used to treat patients with favorable-risk metastatic seminoma, and it has been reported that four cycles of the EP regimen have an efficacy equivalent to that of three cycles of the BEP regimen. 4 In addition, when the BEP regimen cannot be conducted according to the prescribed dosage schedule, an alternative is the cisplatin, etoposide, and ifosfamide (VIP) regimen, which has an efficacy comparable to that of BEP.…”

“…In this issue of IJU Case Report s, Maeda et al . reported the case of a metastatic GCC patient who developed SIADH in the first cycle of BEP induction chemotherapy . In previously reported cases of cisplatin‐related SIADH, cisplatin has been replaced with another drug or chemotherapy has been discontinued; Maeda et al ., however, continued to administer BEP chemotherapy and successfully treated this patient .…”