Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Syndrome of Inappropriate Secretion of Antidiuretic Hormone Following Chemotherapy in a Patient with Non-Small-Cell Lung Cancer

항암화학치료 후 발생한 항이뇨호르몬 부적절 분비 증후군 1예

  • Lee, Kyoung Ju (Department of Internal Medicine, Korea University College of Medicine) ;
  • Moon, Jae Young (Department of Internal Medicine, Korea University College of Medicine) ;
  • Lee, Sung Yong (Department of Internal Medicine, Korea University College of Medicine) ;
  • Lee, Sang Yeub (Department of Internal Medicine, Korea University College of Medicine) ;
  • Kim, Je Hyeong (Department of Internal Medicine, Korea University College of Medicine) ;
  • Shin, Chol (Department of Internal Medicine, Korea University College of Medicine) ;
  • Shim, Jae Jeong (Department of Internal Medicine, Korea University College of Medicine) ;
  • In, Kwang Ho (Department of Internal Medicine, Korea University College of Medicine) ;
  • Kang, Kyung Ho (Department of Internal Medicine, Korea University College of Medicine) ;
  • Yoo, Se Hwa (Department of Internal Medicine, Korea University College of Medicine)
  • 이경주 (고려대학교 의과대학 내과학교실) ;
  • 문재영 (고려대학교 의과대학 내과학교실) ;
  • 이승룡 (고려대학교 의과대학 내과학교실) ;
  • 이상엽 (고려대학교 의과대학 내과학교실) ;
  • 김제형 (고려대학교 의과대학 내과학교실) ;
  • 신철 (고려대학교 의과대학 내과학교실) ;
  • 심재정 (고려대학교 의과대학 내과학교실) ;
  • 인광호 (고려대학교 의과대학 내과학교실) ;
  • 강경호 (고려대학교 의과대학 내과학교실) ;
  • 유세화 (고려대학교 의과대학 내과학교실)
  • Received : 2009.02.24
  • Accepted : 2009.04.10
  • Published : 2009.04.30
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Abstract

The syndrome of inappropriate secretion of the antidiuretic hormone (SIADH) is a well recognized paraneoplastic phenomenon related to impaired water excretion, and can result in dilutional hyponatremia as well as central nervous system symptoms. It is characterized by a decrease in plasma osmolarity with inappropriately concentrated urine. The causes of SIADH are associated with pulmonary and endocrine disorders, central nervous system diseases, and malignancies, including lung cancer. The other causes of SIADH include some drugs, particularly chemotherapy agents. Anticancer drugs, such as cisplatin, vincristine, and cyclophosphamide are well known causes of SIADH but the mechanisms are unclear. Recently, we encountered a patient with advanced non-small cell lung cancer who suffered from general weakness and altered mentality after an intravenous carboplatin and gemcitabine combination.

상기 환자는 진행성 비소세포폐암으로 진단 받고 carboplatin과 gemcitabine의 전신적 항암치료 후에 전신 쇠약 동반한 저나트륨혈증으로 병원에 내원하여 SIADH로 진단받고 carboplatin 약제 중단 후 호전되었다. 이러한 항암제 투여 후에 유발된 SIADH는 여러 가지 원인과의 감별을 요하며, carboplatin에 의해 유발된 SIADH의 보고는 드물기에 증례로 이를 문헌 고찰과 함께 보고하는 바이다.

Keywords

References

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