RESUMEN
INTRODUCTION: Cyclophosphamide is an alkylating agent used in routine pulmonary practice, particularly in the management of connectivitis-related diffuse interstitial lung disease. Common side effects are gastrointestinal disorders and immunosuppression, and a sudden and exceptional adverse effect is severe hyponatremia. OBSERVATION: A 78-year-old female patient treated for NSIP-OP in the context of an anti-synthetase syndrome was treated with Cyclophosphamide 15mg/kg. Twenty-four hours after the end of the infusion, she was diagnosed at home in a coma with comitial seizures. Biological assessment revealed severe hyponatremia at 109 mmol/l with blood hypo-osmolarity. The patient's condition rapidly improved following correction of the ionic disorder. CONCLUSION: Hyponatremia induced by low-dose Cyclophosphamide is a rare but serious adverse effect that requires special attention.
Asunto(s)
Hiponatremia , Síndrome de Secreción Inadecuada de ADH , Anciano , Coma/inducido químicamente , Ciclofosfamida/efectos adversos , Femenino , Humanos , Hiponatremia/inducido químicamente , Hiponatremia/diagnóstico , Hiponatremia/terapia , Síndrome de Secreción Inadecuada de ADH/inducido químicamente , Síndrome de Secreción Inadecuada de ADH/diagnóstico , Convulsiones/inducido químicamenteRESUMEN
Despite recent therapeutic improvements, the prognosis for patients suffering from Sézary syndrome (SS), a disseminated form of cutaneous T-cell lymphomas, is still poor. We identified bi- and monoallelic deletions of the tumor necrosis factor-α-induced protein 3 gene (TNFAIP3; A20) in a high proportion of SS patients as well as biallelic A20 deletion in the SS-derived cell line SeAx. Furthermore, we demonstrate that inhibition of A20 activates the NF-κB pathway thereby increasing the proliferation of normal T lymphocytes. On the other hand, the reconstitution of A20 expression slowed down the cell cycle in SeAx cells. Recently A20 inactivation has been reported in various B-cell lymphomas. In this study, we show that A20 is also a putative tumor suppressor in the T-cell malignancy-SS.