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[A case of syndrome of inappropriate antidiuretic hormone secretion in a patient with esophageal carcinoma possibly induced by cisplatin in neoadjuvant chemotherapy].
[esophageal carcinoma]
A
60
-
year
-old
man
complained
of
dysphagia
and
was
admitted
to
our
hospital
for
adjuvant
chemotherapy
under
a
diagnosis
of
esophageal
carcinoma
(
squamous
cell
carcinoma
[
SCC
]
,
Stage
II
)
.
He
was
treated
with
cisplatin
(
CDDP
)
and
5
-
fluorouracil
(
5
-
FU
)
.
On
the
fifth
day
after
administration
,
he
experienced
mild
disorientation
,
and
early
morning
on
the
sixth
day
,
he
showed
impaired
consciousness
.
Laboratory
studies
revealed
a
serum
sodium
level
of
111
mEq
/
L
and
a
serum
chloride
level
of
73
mEq
/
L
.
The
findings
of
computed
tomography
and
magnetic
resonance
imaging
of
the
head
were
unremarkable
.
Other
laboratory
studies
revealed
a
plasma
vasopressin
level
of
19
.
2
pg
/
mL
,
a
plasma
osmolality
of
219
mOsm
/
kg
,
a
serum
creatinine
level
of
0
.
61
mg
/
dL
,
a
serum
cortisol
level
of
27
.
1
mg
/
dL
,
a
urine
osmolality
of
665
mOsm
/
kg
,
and
a
urine
sodium
level
of
157
.
1
mEq
/
L
.
There
were
no
signs
of
dehydration
,
and
so
the
patient
was
diagnosed
with
syndrome
of
inappropriate
antidiuretic
hormone
secretion
(
SIADH
)
.
We
discontinued
chemotherapy
and
initiated
fluid
restriction
and
sodium
supplementation
.
After
this
treatment
,
the
patient
's
consciousness
progressively
improved
.
On
the
fifth
day
of
treatment
,
laboratory
studies
revealed
a
serum
sodium
level
of
138
mEq
/
L
and
a
serum
chloride
level
of
98
mEq
/
L
,
indicating
recovery
from
hyponatremia
.
Diseases
Validation
Diseases presenting
"fifth day"
symptom
esophageal carcinoma
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