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Vol. 30, No. 12, 2007
Issue release date: November 2007
Onkologie 2007;30:651-654

Severe Hyponatremia in a Patient with Mantle Cell Lymphoma Treated with Bortezomib: A Case Report and Review of the Literature

Brodmann S. · Klaas E.G. · Cathomas R. · Girardi V. · von Moos R.
aAbteilung Onkologie/Hämatologie, Departement Innere Medizin, bInstitut für Spitalpharmazie, Departement Institute, Kantonsspital Graubünden, Chur cNephrologie/Dialyse, Medizinische Klinik, Kantonsspital Winterthur, Switzerland

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Background: Hyponatremia is a known complication of cytotoxic treatment. We observed this side effect in a patient treated with bortezomib. This paper gives an overview of the literature on antineoplastic agents that have been associated with hyponatremia. Case Report: A 77-year-old female patient with mantle cell lymphoma was admitted with rapidly progressive ataxia, slurred speech, and confusion. 43 days earlier, a second-line treatment with the proteasome inhibitor bortezomib had been started. Neurological examination revealed no focal deficits. Laboratory evaluation showed a combined electrolyte disorder with severe hyponatremia (sodium 112 mmol/l). Results: A syndrome of inappropriate secretion of antidiuretic hormone (SIADH) was diagnosed, and bortezomib was identified as its cause. The drug was consecutively stopped. CT scan showed a complete remission (CR). Since, the patient has remained in a CR without further tumor-specific treatment. Conclusion: Hyponatremia may be a side effect of treatment with bortezomib and a number of other antineoplastic agents. Because of limited data available, accurate incidences of this complication are not known.

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