Syndrome of inappropriate antidiuretic hormone secretion following irinotecan-cisplatin administration as a treatment for recurrent ovarian clear cell carcinoma

Abstract

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) has various causes including central nervous system disorders, pulmonary and endocrine diseases, paraneoplastic syndromes, and use of certain drugs. SIADH induced by chemotherapy with irinotecan-cisplatin is not a common complication. Here, we review a case of SIADH after treatment with irinotecan-cisplatin. A 45-year-old woman received adjuvant chemotherapy (paclitaxel-carboplatin) for ovarian clear cell carcinoma, but the cancer recurred within 9 months of chemotherapy. Subsequently, a second line of combination chemotherapy containing irinotecan-cisplatin was initiated. However, 5 days after chemotherapy administration, her general condition began to deteriorate; her hematological tests revealed hyponatremia. Therefore, it is imperative to consider the possibility of SIADH in patients being treated with irinotecan-cisplatin–based chemotherapy. Proper monitoring of serum sodium levels and assessment of clinical symptoms should be performed in such patients for early diagnosis and prompt management.

Risk Factors for Severe Hyponatremia Related to Cisplatin: A Retrospective Case-Control Study

“…10) Some case reports showed that severe hyponatremia following CDDP administration induced cessation of chemotherapy. 16,17) Ezoe et al evidenced that the incidence of severe hyponatremia following platinum-based chemotherapy varied among different types of cancer (5.4-19.9%), and grade 4 hyponatremia was significantly higher in patients with SCLC than others. 10) Relative to previous investigations, the present study showed a comparable incidence of grade ≥3 hyponatremia.…”

Electrolyte Disorders Induced by Antineoplastic Drugs

“…Electrolyte disorders are also related to cisplatin-induced DNA damage of thiazide-sensitive sodiumchloride co-transporter genes and to the apoptosis of distal tubule cells (34). Cisplatin treatment may cause hyponatremia through SIADH, related to both higher secretion of and sensitivity to ADH (32). Nausea and vomiting, which are common side effects of platinum-derived chemotherapy, are also powerful stimuli for ADH secretion.…”

Peripherally administered cisplatin activates a parvocellular neuronal subtype expressing arginine vasopressin and enhanced green fluorescent protein in the paraventricular nucleus of a transgenic rat

“…Peripheral administration of cisplatin may not stimulate parvocellular neurons in the pPVN directly, as indicated, secondary effects, including side effects such as emetic reactions, may activate parvocellular neurons in the pPVN. Cisplatin induces not only nausea/vomiting but also other side effects such as syndrome of inappropriate antidiuretic hormone (SIADH) and impaired cognitive functions [26][27][28][29][30][31]. The possible mechanisms of cisplatin-induced SIADH are as follows: (1) cisplatininduced vomiting/hypovolemia may stimulate AVP synthesis/secretion, (2) cisplatin may activate AVP neurons in the hypothalamus directly, and (3) continuous secretion of AVP into the portal vein in the external layer of the median eminence projected from the pPVN [26,27].…”

“…Cisplatin induces not only nausea/vomiting but also other side effects such as syndrome of inappropriate antidiuretic hormone (SIADH) and impaired cognitive functions [26][27][28][29][30][31]. The possible mechanisms of cisplatin-induced SIADH are as follows: (1) cisplatininduced vomiting/hypovolemia may stimulate AVP synthesis/secretion, (2) cisplatin may activate AVP neurons in the hypothalamus directly, and (3) continuous secretion of AVP into the portal vein in the external layer of the median eminence projected from the pPVN [26,27]. Cisplatin-induced impairment of learning and memory may be caused by direct toxic effects on neurons, in particular hippocampal neurons [28][29][30].…”