[尿管癌化疗副反应抗利尿激素分泌不当综合征1例]。

Q4 Medicine Japanese Journal of Urology Pub Date : 2021-04-20 DOI:10.5980/jpnjurol.112.100
Koki Maeda, Yuri Mori, M. Nakamura, Yoshimasa Harada, K. Kodama
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引用次数: 1

摘要

一名54岁女性因肉眼血尿和排尿困难入院。膀胱镜检查发现膀胱顶部有一个4厘米大小的钙化肿瘤。经尿道膀胱切除术诊断为尿管癌后,行部分膀胱切除术合并脐正中韧带整体切除术及盆腔淋巴结切除术。病理诊断为尿管癌,pT3b, ly1, v0, pN1, RM0。给予TS-1和顺铂化疗(TS-1 100mg /天,第1-21天,CDDP 60mg /m2,第8天)。第13天,患者因意识障碍(格拉斯哥昏迷量表E2V1M4)入院。患者出现低钠血症(Na 109 mEq/l)及肾钠排泄,诊断为化疗所致抗利尿激素分泌不当综合征(SIADH)。给予3%生理盐水后,患者血清钠水平及意识水平逐渐改善。含有顺铂的化疗引起的SIADH是一种相对罕见的,但潜在的严重不良反应需要密切关注。
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[SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE SECRETION AS A SIDE EFFECT OF CHEMOTHERAPY FOR URACHAL CARCINOMA: A CASE REPORT].
A 54-year-old woman was admitted to our hospital complaining of gross hematuria and difficulty urinating. Cystoscopy revealed a tumor 4 cm in size with calcification on top of the bladder. After diagnosis of urachal carcinoma by transurethral resection of the bladder, partial cystectomy with en bloc resection of the median umbilical ligament and pelvic lymphadenectomy was performed. Pathological diagnosis confirmed urachal carcinoma, pT3b, ly1, v0, pN1, RM0. TS-1 and cisplatin chemotherapy (TS-1 at 100 mg/day on days 1-21, CDDP at 60 mg/m2 on day 8) was administered. On day 13, the patient was admitted because of consciousness disorder (Glasgow Coma Scale E2V1M4). Hyponatremia (Na 109 mEq/l) and renal excretion of sodium were present and the patient was diagnosed with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) induced by chemotherapy. Serum sodium level and her consciousness level gradually improved after administration of 3% saline. SIADH caused by chemotherapy containing cisplatin is a relatively rare, but potentially serious adverse effect that requires close attention.
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来源期刊
Japanese Journal of Urology
Japanese Journal of Urology Medicine-Urology
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