A Case of Refractory Syndrome of Inappropriate Secretion of Antidiuretic Hormone Accompanying Small Cell Lung Cancer Successfully Treated with Tolvaptan

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  • Tomomatsu Katsuyoshi
    Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine
  • Oguma Tsuyoshi
    Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine
  • Tomomatsu Hiromi
    Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine
  • Urano Tetsuya
    Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine
  • Asano Koichiro
    Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine
  • Abe Tadashi
    Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine

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Other Title
  • 肺小細胞癌による難治性抗利尿ホルモン不適合分泌症候群に対しトルバプタンが著効した1例

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Description

Background. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a disorder of impaired water excretion and hyponatremia by the excess secretion of arginine-vasopressin (AVP). We report a case of refractory SIADH accompanying small cell lung cancer (SCLC), successfully treated with an AVP V2 receptor antagonist, tolvaptan. Case. A 70-year-old man presented with bloody sputum and cough for 4 months, anorexia for 1 month, and dyspnea on effort for 2 weeks. He was diagnosed as SCLC complicated with superior vena cava syndrome and hyponatremia and referred to our hospital. He received chemotherapy with carboplatin and etoposide. His hyponatremia, diagnosed as SIADH, was resistant to the treatments with hypertonic saline and furosemide under fluid restriction for 3 weeks. Therefore, tolvaptan, 7.5 mg qd, was started, resulting in the normalization of serum sodium level in 2 days and the improvement of conscious level. He has experienced no adverse events with tolvaptan therapy, but remains dependent on tolvaptan in spite of the tumor regression. Conclusion. Tolvaptan is an effective therapy to control refractory SIADH accompanying SCLC.<br>

Journal

  • Haigan

    Haigan 53 (1), 42-46, 2013

    The Japan Lung Cancer Society

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