Symptomatic hyponatraemia caused by cylophosphamide.

ABSTRACT

BACKGROUND: Acute hyponatraemia after administration of alkylating agents such as cyclophosphamide or ifosfamide has been documented as an infrequent but life-threatening complication. CASE REPORT A 69-year-old female patient with metastatic adenocarcinoma of the salivary glands presented with severe symptomatic hyponatraemia (nadir 112 mmol/l) after chemotherapy with cyclophosphamide, cisplatin, and doxorubicin. Serum sodium was carefully corrected at the intensive care unit. The patient recovered completely from her neurological symptoms within a couple of days. A literature review showed only few cases with cyclophosphamide-induced acute hyponatraemia, and to our knowledge this is the first case where hyponatraemia was seen with a dose of only 500 mg/m(2) of cyclophosphamide. CONCLUSION: Oncologists should be aware of cyclophosphamide-induced acute hyponatraemia as a rare but life-threatening side-effect, especially since its clinical features may mimic those of chemotherapy-induced nausea.