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- MATSUYAMA Sho
- Department of Gastroenterology, Tenri Hospital
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- UEO Taro
- Department of Gastroenterology, Tenri Hospital
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- OZAWA Tomomi
- Department of Gastroenterology, Tenri Hospital
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- MATSUMOTO Atsushi
- Department of Gastroenterology, Tenri Hospital
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- MINAMI Ryuki
- Department of Gastroenterology, Tenri Hospital
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- KIMURA Yuto
- Department of Gastroenterology, Tenri Hospital
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- TAKEDA Yasuhiro
- Department of Gastroenterology, Tenri Hospital
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- OKANO Akihiro
- Department of Gastroenterology, Tenri Hospital
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- KUSUMI Fusako
- Department of Gastroenterology, Tenri Hospital
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- OHANA Masaya
- Department of Gastroenterology, Tenri Hospital
Bibliographic Information
- Other Title
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- トルバプタンが奏功した膵癌によるSIADHの1例
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Abstract
<p>We report the case of a 68-year-old man, who presented in emergency care with inarticulate speech. The patient was diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) associated with pancreatic cancer. All diagnostic criteria for SIADH were met, and cancer of the pancreatic tail was identified by computed tomography. Standard treatment for SIADH includes water restriction, oral NaCl, continuous intravenous infusion of 3% NaCl, and intravenous infusion of furosemide. However, these treatments have varying effectiveness and are difficult for both patients and medical staff. Furthermore, unless treatment of the underlying disease is successful, continued hospitalization is needed and the patient's quality of life is significantly impaired. In this case, hyponatremia improved with this standard treatment, but ascites and edema developed. We treated the patient with tolvaptan due to decreased cardiac function, and symptoms improved rapidly. Although surgery and chemotherapy could not be performed for pancreatic cancer, the SIADH was treated for 7 months without relapse. In summary, a case of SIADH complicated by pancreatic cancer was difficult to control with standard treatment, but responded rapidly to tolvaptan, and outpatient treatment could be continued for a long period. Tolvaptan is useful for the treatment of SIADH associated with cancer.</p>
Journal
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- Nippon Shokakibyo Gakkai Zasshi
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Nippon Shokakibyo Gakkai Zasshi 119 (2), 172-178, 2022-02-10
The Japanese Society of Gastroenterology