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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
"dehydration"
symptom
aniridia
esophageal carcinoma
familial hypocalciuric hypercalcemia
harlequin ichthyosis
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
lamellar ichthyosis
systemic capillary leak syndrome
This symptom has already been validated