内容紹介
Summary
We herein report a case of a consciousness disorder that was induced by the syndrome of inappropriate antidiuretic hormone secretion following cisplatin(CDDP)and 5-fluorouracil(5-FU)chemotherapy in a patient with tongue cancer. A 72-year-old woman complained of tongue pain and was admitted to our hospital for neoadjuvant chemotherapy, under a diagnosis of tongue squamous cell carcinoma(T4aN2bM0). She was treated with CDDP and 5-FU. On the second day after administration, she complained of nausea and anorexia, and on the third day, she showed impaired consciousness. Laboratory studies revealed that the patient had a serum sodium concentration 112 mEq/L, and no dehydration was noted. The patient was diagnosed with SIADH, using the appropriate diagnostic criteria based on serum and urine hypoosmolality. We subsequently discontinued chemotherapy and initiated fluid restriction and sodium supplements. Two days after this treatment, her consciousness level improved, and on the fifth day of treatment, laboratory studies revealed a serum sodium level of 134 mEq/L.
要旨
今回われわれは,cisplatin(CDDP),5-fluorouracil(5-FU)(PF療法)施行中にSIADHによる意識障害を来した舌癌の1例を経験したので,その概要について報告する。症例は72歳,女性。右舌の痛みを主訴に受診し,右側舌【扁】平上皮癌(T4aN2bM0)の診断下に術前化学療法のために入院し,PF療法を施行した。day 2から嘔気があり食欲不振を認め,day 3には意識障害を来した。急激な低Na血症(血清Na 112 mEq/L)や血液尿検査所見などからSIADHが考えられた。意識障害発症後から電解質の補正を開始し,発症2日後には意思疎通が可能な状態にまで改善し,発症後5日目には血清Na値が134 mEq/Lにまで回復した。
目次
We herein report a case of a consciousness disorder that was induced by the syndrome of inappropriate antidiuretic hormone secretion following cisplatin(CDDP)and 5-fluorouracil(5-FU)chemotherapy in a patient with tongue cancer. A 72-year-old woman complained of tongue pain and was admitted to our hospital for neoadjuvant chemotherapy, under a diagnosis of tongue squamous cell carcinoma(T4aN2bM0). She was treated with CDDP and 5-FU. On the second day after administration, she complained of nausea and anorexia, and on the third day, she showed impaired consciousness. Laboratory studies revealed that the patient had a serum sodium concentration 112 mEq/L, and no dehydration was noted. The patient was diagnosed with SIADH, using the appropriate diagnostic criteria based on serum and urine hypoosmolality. We subsequently discontinued chemotherapy and initiated fluid restriction and sodium supplements. Two days after this treatment, her consciousness level improved, and on the fifth day of treatment, laboratory studies revealed a serum sodium level of 134 mEq/L.
要旨
今回われわれは,cisplatin(CDDP),5-fluorouracil(5-FU)(PF療法)施行中にSIADHによる意識障害を来した舌癌の1例を経験したので,その概要について報告する。症例は72歳,女性。右舌の痛みを主訴に受診し,右側舌【扁】平上皮癌(T4aN2bM0)の診断下に術前化学療法のために入院し,PF療法を施行した。day 2から嘔気があり食欲不振を認め,day 3には意識障害を来した。急激な低Na血症(血清Na 112 mEq/L)や血液尿検査所見などからSIADHが考えられた。意識障害発症後から電解質の補正を開始し,発症2日後には意思疎通が可能な状態にまで改善し,発症後5日目には血清Na値が134 mEq/Lにまで回復した。