卵巣癌化学療法に続発した低ナトリウム血症の1例

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A 68 year-old woman with stage IIIc ovarian mesodermal mixed tumor, heterologus type, underwent postoperative adjuvant chemotherapy with cisplatin and ifosfamide. Before chemotherapy, her serum sodium level was 138 mEq/1, but it dropped to 119 mEq/1 on day 5. The patient had no history of excessive sweating or gastrointestinal fluid loss, consciousness was clear, and no dehydration, ascites nor edemawas noted. Under differetial diagnoses of renal tubular dysfunction or syndrome of inappropriate secretion of antidiuretic hormone(SIADH), she was treated with gradual sodium supplementation and fluid restriction. Serum sodium returned to 135 mEq/1 on day 8. Urinary β_2 microglobulin(β_2MG) temporarily rose to 26.9mg/1 on day 10, and this transient rise was strong evidence that renal tubular dysfunction was the main cause of hyponatremia after chemotherapy. As distinguishing between renal tubular dysfusction and SIADH is imperative in administering proper treatment, we found measuring urinary β_2MG to be useful.
社団法人日本産科婦人科学会の論文
2001-07-01