Hiponatreminin Nadir Bir Nedeni: Siklofosfamit

Öz

Hiponatremi en sık görülen elektrolit bozukluğu olup hastanede yatan hastaların %10-15’inde görülmektedir. SİAD ise övolemik hiponatreminin sık bir nedenidir ve başta maligniteler ve bazı ilaçlar olmak üzere pek çok faktöre bağlı görülebilir. Bu ilaçlar arasında siklofosfamit oldukça nadir görülen bir ajandır. Bu yazıda siklofosfamit kullanımına ikincil olarak gelişen akut hiponatremi olgusunu sunmayı ve bu nadir nedene dikkat çekmeyi amaçladık.

Anahtar Kelimeler

• hiponatremi,siad,siklofosfamit

A Rare Cause Of Hyponatremia: Cyclophosphamide Hiponatreminin

Abstract

Hyponatremia is the most common electrolyte disorder and occurs in %10-15 of hospitalized patient. SIADH is a frequent cause of normovolemic hyponatremia and mostly induced by malignancy and many drugs. Cyclophosphamide is a rare agent among this drugs. In this article, we aimed to report the case of acut hyponatremia due to cyclophosphamide and point to this rare cause.

Keywords

• hyponatemia,SIADH,cyclophosphamide

References

1. 1. Upadhyay A, Jaber BL, Madias NE. Incidence and prevalence of hyponatremia. Am J Med 2006; 119: 30-35.
2. 2. Spasovski G, Vanholder R, Allolio B, Annane D, Ball S, Bichet D, Decaux G, Fenske W, Hoorn EJ, Ichai C, Joannidis M, Soupart A, Zietse R, Haller M, Van der Veer S, Van Biesen V, Nagler E. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Nephrology Dialysis Transplantation 2014; 29 (Supplement 2) 1–39.
3. 3. Singer GG, Brenner BM. Fluid and electrolyte disturbances. In: Fauci AS, Kasper DL, Longo DL, Braunwald E, Hauser SL, Jameson JL, Loscalzo J. Harrison’s Principals of Internal Medicine. 17thed. New York: Mc Graw Hill, 2008: 274-84.
4. 4. Schwartz WB, Bennett W, Curelop S, Bartter FC: A syndrome of renalsodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. Am J Med 1957; 23: 529–542.
5. 5. Esposito P, Piotti G, Bianzina S, Malul Y, Dal Canton A. The Syndrome of Inappropriate Antidiuresis: Pathophysiology, Clinical Management and New Therapeutic Options. Nephron Clin Pract. 2011; 119(1): 62-73
6. 6. HİPOFİZ HASTALIKLARI TANI, TEDAVİ ve İZLEM KILAVUZU Türkiye Endokrinoloji ve Metabolizma Derneği, 2017; 109-110
7. 7. Pelosof LC and Gerber DE. Paraneoplastic Syndromes: An Approach to Diagnosis and Treatment Mayo Clin Proc. 2010; 85(9): 838–854.
8. 8. Dimitriadis GK, Angelousi A, Weickert MO, Randeva HS, Kaltsas G, Grossman A . Paraneoplastic endocrine syndromes. Endocr Relat Cancer. 2017; 24(6):173-190

9. 9. Erkurt MA, Kuku İ, Kaya E, Aydoğdu İ. Kanser Kemoterapisi ve Böbrek. İnönü Üniversitesi Tıp Fakültesi Dergisi 2009; 16(1). 63-68
10. 10. Esposito P, Domenech MV, Serpieri N, Calatroni M, Massa I, Avella A, La Porta E, Estienne L, Caramella E, Rampino T. Severe cyclophosphamiderelated hyponatremia in a patient with acute glomerulonephritis. World J Nephrol. 2017; 6(4): 217–220.
11. 11. Moses AM, Miller M. Drug-induced dilutional hyponatremia. N Engl J Med. 1974 Dec 5; 291(23): 1234-1239.
12. 12. Baker M, Markman M, Niu J. Cyclophosphamide-Induced Severe Acute Hyponatremic Encephalopathy in Patients with Breast Cancer: Report of Two Cases 2014; 7(2): 550–554.
13. 13. Bruining DM, van Roon EN, de Graaf H, Hoogendoorn M. Cyclophosphamide- induced symptomatic hyponatraemia. Neth J Med. 2011; 69(4): 192-195
14. 14. Park S, Kim W, Choi HY, Yoon JH, Ha SK, Park H. Severe Symptomatic Hyponatremia Caused by Low Dose Oral Cyclophosphamide: A Case Report. The Korean Journal of Nephrology 2011; 30: 647-650
15. 15. Elazzazy S, Mohamed AE, Gulied A. Cyclophosphamide-induced symptomatic hyponatremia, a rare but severe side effect: a case report.Onco Targets Ther. 2014; 7: 1641–1645.
16. 16. Geng C, Tang P, Zhang Y, Gao W. Hyponatremia induced by lowdose cyclophosphamide in two patients with breast cancer. Breast J. 2014;20(4): 442-443.
17. 17. Lazarevic V, Hägg E, Wahlin A. Hiccups and severe hyponatremia associated with high-dose cyclophosphamide in conditioningregimen for allogeneic stem cell transplantation. Am J Hematol. 2007; 82(1):88