2014 Volume 111 Issue 9 Pages 1805-1810
A woman in her eighties underwent transcatheter arterial chemoembolization (TACE) with cisplatin (CDDP) for recurrence of hepatocellular carcinoma (HCC) with lymph node involvement and associated hepatitis C. She was restless and had a disturbed consciousness for the next 28 hours. Laboratory tests revealed a serum sodium level of 116 mEq/L, which had decreased from that observed at admission (136 mEq/L). She had high levels of urinary sodium, serum hypoosmolarity, and urine hyperosmolarity. She was diagnosed with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) secondary to treatment with CDDP and the hypotonic infusions used for hydration. After treatment with isotonic saline, she regained consciousness on day 4.