Asymptomatic Hyponatremia due to Inappropriate Secretion of Antidiuretic Hormone as the First Sign of a Small Cell Lung Cancer in an Elderly Man

Kyuzi KAMOI; Izumi KUROKAWA; Hidehiro KASAI; Akio MIZUSAWA; Tatsuo EBE; Hideo SASAKI; Yoshiko MATUZUKI; Yasuyuki SEINO; Masashi TAKAHASHI; Ken-ichi TOGASHI; Haruo MIYAMURA; Yoshitomo SATO; Hideaki TAKATO; Hiroshi KANEKO

doi:10.2169/internalmedicine.37.950

Kyuzi KAMOI, Izumi KUROKAWA, Hidehiro KASAI, Akio MIZUSAWA, Tatsuo EBE, Hideo SASAKI, Yoshiko MATUZUKI, Yasuyuki SEINO, Masashi TAKAHASHI, Ken-ichi TOGASHI, Haruo MIYAMURA, Yoshitomo SATO, Hideaki TAKATO, Hiroshi KANEKO

Author information

Kyuzi KAMOI
The Departments of Internal Medicine, Nagaoka Red Cross Hospital
Izumi KUROKAWA
The Departments of Internal Medicine, Nagaoka Red Cross Hospital
Hidehiro KASAI
The Departments of Internal Medicine, Nagaoka Red Cross Hospital
Akio MIZUSAWA
The Departments of Internal Medicine, Nagaoka Red Cross Hospital
Tatsuo EBE
The Departments of Internal Medicine, Nagaoka Red Cross Hospital
Hideo SASAKI
The Departments of Internal Medicine, Nagaoka Red Cross Hospital
Yoshiko MATUZUKI
The Departments of Radiology, Nagaoka Red Cross Hospital
Yasuyuki SEINO
The Departments of Radiology, Nagaoka Red Cross Hospital
Masashi TAKAHASHI
The Departments of Thoracic and Cardiovascular Surgery, Nagaoka Red Cross Hospital
Ken-ichi TOGASHI
The Departments of Thoracic and Cardiovascular Surgery, Nagaoka Red Cross Hospital
Haruo MIYAMURA
The Departments of Thoracic and Cardiovascular Surgery, Nagaoka Red Cross Hospital
Yoshitomo SATO
The Departments of Thoracic and Cardiovascular Surgery, Nagaoka Red Cross Hospital
Hideaki TAKATO
The Departments of Pathology, Nagaoka Red Cross Hospital
Hiroshi KANEKO
The Departments of Pathology, Nagaoka Red Cross Hospital

Keywords: paraneoplastic syndrome, vasopressin, syndrome of inappropriate secretion of antidiuretic hormone (SIADH), osmoregulation, renin

JOURNAL FREE ACCESS

1998 Volume 37 Issue 11 Pages 950-954

DOI https://doi.org/10.2169/internalmedicine.37.950

Details

Abstract

A 72-year-old man was hospitalized with asymptomatic hyponatremia. Despite hyponatremia, urinary sodium excretion with urine osmolality exceeding plasma osmolality persisted. Plasma vasopressin levels were high and independent of plasma osmolality during hypertonic saline infusion. Computed tomography of the chest showed enlarged mediastinal and right hilar lymph nodes. Microscopically, a specimen of lymph nodes obtained by biopsy represented vasopressinproducing small cell lung carcinoma. Chemotherapy plus irradiation improved the hyponatremia. Thus, careful evaluation is necessary to determine the cause of hyponatremia disorders in elderly patients.
(Internal Medicine 37: 950-954, 1998)

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