Syndrome of Inappropriate Antidiuretic Hormone Secretion Following Chemotherapy with Cisplatinum and 5-FU in a Patient with Esophageal Cancer

Daisaku Morita, Takashi Ichikura, Mikihiko Kimura, Kentaro Chochi, Susumu Saigusa, Yoshihisa Yaguchi, Naoko Sakamoto and Hidetaka Mochizuki

Department of Surgery I, National Defense Medical College

We report here a case of esophageal cancer complicated by syndrome of inappropriate secretion of antidiuretic hormone (SIADH) following cisdichlorodiamimnine platinum (CDDP) and 5-FU administration. A 66-year-old male developed dysphasia, and was found with a squamous cell carcinoma of esophagus (T4N1M0). He was treated with CDDP and 5-FU. The serum sodium concentration decreased from 123 mEq/l to 105 mEq/l after chemotherapy. SIADH was diagnosed on the basis of hyponatremia with corresponding serum hypoosmolality and an inappropriatelu high urinary osmolality due to continued sodium excretion. In our case, SIADH was probably induced by CDDP. Fluid restriction and sodium supplement resulted in an appropriate rise in the serum sodium level to 126 mEq/l in 3 days.

Key words
esophageal cancer, syndrome of inappropriate antidiuretic hormone secretion, cisplatin

Reprint requests
Daisaku Morita Department of Pathology II, National Defense Medical College
3-2 Namiki, Tokorozawa, 359-8513 JAPAN

Accepted
January 26, 2005

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