恶性肿瘤低钠血症1例

Diana Gemanari, Alina Dobrotă, C. Diaconu
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引用次数: 0

摘要

低钠血症是一种常见的电解质失衡,有多种病因,可能继发于化疗或自身免疫性疾病。我们报告一例76岁的女性,她表现出严重的低钠血症症状,如消化不耐受、恶心、呕吐、全身肌肉无力和眩晕,血清钠水平为110 mEq/L。患者有多种心血管和恶性合并症,被诊断为右乳腺肿瘤,右乳房根治术和腋窝淋巴结切除术。随后,检测到多发腺病变,这就是为什么患者接受了曲妥珠单抗和卡培他滨几个系列的化疗。这些药物可引起副作用,如干眼、口干,这也是自身免疫性疾病中经常遇到的。低钠血症是卡培他滨最常见的副作用之一。所有这些副反应随后进行了调查,从而根据免疫学检查,建立了干燥综合征的诊断。在排除其他原因后,确定低钠血症继发于近期服用卡培他滨或抗利尿激素分泌不当综合征(SIADH),这可能是干燥综合征的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hyponatremia in malignant neoplasia: A case report
Hyponatremia is a frequent electrolyte imbalance with diverse etiology that may occur secondary to chemotherapy or autoimmune pathologies. We report the case of a 76-years-old female who presented for symptoms of severe hyponatremia like digestive intolerance, nausea, vomiting, generalized muscle weakness and vertigo, with a serum sodium level of 110 mEq/L. The patient was known with multiple cardiovascular and malignant comorbidities, being diagnosed with a right breast neoplasm with right radical mastectomy and axillary lymphadenectomy. Subsequently, multiple adenopathies were detected, which is why the patient followed several series of chemotherapy with trastuzumab and capecitabinum. These drugs can cause side effects, such as xerophthalmia, xerostomia, which are also frequently encountered in autoimmune pathologies. Hyponatremia is one of the most frequent side effects of capecitabinum. All these side reactions were investigated later, thus following the immunological tests, the diagnosis of Sjogren's syndrome was established. After ruling out other causes, it was established that hyponatremia appeared secondary to the recent administration of capecitabinum or within a syndrome of inappropriate antidiuretic hormone secretion (SIADH), which can be the result of a Sjogren's syndrome.
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