Severe cyclophosphamide-related hyponatremia in a patient with acute glomerulonephritis
| Autor: | Elena Caramella, Edoardo La Porta, Marta Calatroni, Pasquale Esposito, Luca Estienne, Alessandro Avella, Nicoletta Serpieri, Ilaria Massa, Maria Valentina Domenech, Teresa Rampino |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Cyclophosphamide Antidiuretic hormone Urinary system 030232 urology & nephrology Case Report Urine osmolality 030204 cardiovascular system & hematology Gastroenterology 03 medical and health sciences 0302 clinical medicine Glomerulonephritis Internal medicine Medicine Rapidly progressive glomerulonephritis business.industry Acute kidney injury medicine.disease Hypertonic solutions business Hyponatremia Syndrome of inappropriate antidiuresis Hemorrhagic cystitis medicine.drug |
| Zdroj: | World Journal of Nephrology |
| ISSN: | 2220-6124 |
| Popis: | Cyclophosphamide is frequently used to treat cancer, autoimmune and renal diseases, such as rapidly progressive glomerulonephritis. Its side effects are well-known, including bone marrow depression, infections, alopecia, sterility, bladder malignancy and hemorrhagic cystitis. Moreover, in some cases cyclophosphamide use has been related to the onset of hyponatremia, by development of a syndrome of inappropriate antidiuresis. Indeed, severe hyponatremia has been previously reported in patients treated with high-dose or moderate-dose of intravenous cyclophosphamide, while only few cases have been reported in patients treated with low dose. Here, we discuss a case of a syndrome of inappropriate antidiuresis followed to a single low-dose of intravenous cyclophosphamide in a patient with a histological diagnosis of acute glomerulonephritis, presenting as acute kidney injury. After cyclophosphamide administration (500 mg IV), while renal function gradually improved, the patient developed confusion and headache. Laboratory examinations showed serum sodium concentration dropped to 122 mmol per liter associated with an elevated urinary osmolality of 199 mOsm/kg, while common causes of acute hyponatremia were excluded. He was successfully treated with water restriction and hypertonic saline solution infusion with the resolution of the electrolyte disorder. This case, together with the previous ones already reported, highlights that electrolyte profile should be strictly monitored in patients undergoing cyclophosphamide therapy in order to early recognize the potentially life-threatening complications of acute water retention. |
| Databáze: | OpenAIRE |
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