Related Experiment Video
Updated: Jun 23, 2026
07:38
Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin
Published on: May 6, 2018
Symptomatic hyponatraemia caused by cylophosphamide.
Anne Katrin Berger1, Frauke Bellos, Annika Siegmund
1Nationales Centrum fur Tumorerkrankungen, Universitatsklinikum Heidelberg, Im Neuenheimer Feld 350, Heidelberg, Germany.
Onkologie
|May 8, 2009
Summary
Cyclophosphamide chemotherapy can cause acute hyponatraemia, a rare but serious side effect. This case highlights the risk even at lower doses, emphasizing the need for physician awareness.
Area of Science:
- Oncology
- Nephrology
- Clinical Pharmacology
Background:
- Acute hyponatraemia is a rare, life-threatening complication associated with alkylating agents like cyclophosphamide and ifosfamide.
- Chemotherapy regimens, particularly those including cyclophosphamide, can precipitate electrolyte disturbances.
- Understanding the risk factors and presentation of chemotherapy-induced hyponatraemia is crucial for patient safety.
Observation:
- A 69-year-old female with metastatic salivary gland adenocarcinoma developed severe symptomatic hyponatraemia (nadir 112 mmol/l) following treatment with cyclophosphamide, cisplatin, and doxorubicin.
- The patient's serum sodium levels were managed in the intensive care unit, leading to complete neurological recovery.
- This case is notable as it represents the first documented instance of hyponatraemia associated with a cyclophosphamide dose as low as 500 mg/m(2).
Findings:
- Cyclophosphamide, even at a dose of 500 mg/m(2), can induce acute, severe hyponatraemia.
- The clinical presentation of chemotherapy-induced hyponatraemia may be mistaken for chemotherapy side effects like nausea.
- Prompt recognition and management of hyponatraemia are essential for favorable patient outcomes.
Implications:
- Oncologists must maintain a high index of suspicion for cyclophosphamide-induced acute hyponatraemia.
- Awareness of this rare but severe adverse event is critical, especially given its potential to mimic other chemotherapy-related symptoms.
- This case underscores the importance of vigilant electrolyte monitoring during cyclophosphamide-based chemotherapy.
Related Concept Videos
01:27Cryptococcal Meningitis
Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
01:24Nephrotic Syndrome I : Introduction
Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of fluid...
01:24Hemodialysis II: Procedure and Complications
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
01:24Nephrotic Syndrome III : Nursing Management
Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...
01:21Hyperosmolar Hyperglycemic State
Hyperosmolar Hyperglycemic State, or HHS, is a serious and life-threatening complication of type 2 diabetes mellitus. It is characterized by three main features: severe hyperglycemia, profound dehydration, and elevated serum osmolality, all occurring without significant ketoacidosis.HHS typically develops in older adults or individuals with limited access to fluids. This may result from illness, cognitive impairment, or medications such as diuretics or corticosteroids. These factors reduce...
01:22Diabetes Insipidus II: Pathophysiology
Normally, water balance is maintained through three interconnected mechanisms: the hypothalamic thirst center, the synthesis and release of antidiuretic hormone (ADH, or vasopressin), and the kidneys' responsiveness to this hormone. ADH is synthesized in the hypothalamus, released from the posterior pituitary, and acts on the distal nephron, allowing water reabsorption and concentrated urine production.Diabetes Insipidus and Its TypesIn diabetes insipidus (DI), this regulatory system is...