{"id":6923,"date":"2022-05-09T11:21:03","date_gmt":"2022-05-09T10:21:03","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=6923"},"modified":"2022-05-16T12:30:14","modified_gmt":"2022-05-16T11:30:14","slug":"severe-hyponatraemia-in-two-patients-with-breast-cancer-caused-by-low-dose-cyclophosphamide-and-precipitated-by-aprepitant-2022","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2022\/05\/09\/severe-hyponatraemia-in-two-patients-with-breast-cancer-caused-by-low-dose-cyclophosphamide-and-precipitated-by-aprepitant-2022\/","title":{"rendered":"Severe hyponatraemia in two patients with breast cancer caused by low-dose cyclophosphamide and precipitated by aprepitant (2022)"},"content":{"rendered":"<p><strong>Type of publication:<\/strong><br \/>\nJournal article<\/p>\n<p><strong>Author(s):<\/strong><br \/>\n*Parikh S; *Pettit L; *AbdelGadir H<\/p>\n<p><strong>Citation:<\/strong><br \/>\nBMJ Case Reports, 2022 Mar 22; Vol. 15<\/p>\n<p><strong>Abstract:<\/strong><br \/>\nTwo postmenopausal women with breast cancer developed acute confusion and seizures, less than 24 hours after the first cycle of neoadjuvant chemotherapy with fluorouracil, epirubicin and low-dose cyclophosphamide. They were found to have severe, life-threatening hyponatraemia with sodium levels of 113 and 115 mEq\/L, respectively. Both women made a full recovery within 24 hours of admission with slow correction of sodium levels. Following investigational workup, the most likely diagnosis was cyclophosphamide-associated syndrome of inappropriate antidiuretic hormone secretion (SIADH). Aprepitant \u2013 a commonly used antiemetic and moderate cytochromeP450 3A4 inhibitor was identified as the precipitating factor. Aprepitant was discontinued and both women were successfully re-challenged with full dose cyclophosphamide in an outpatient setting with no subsequent adverse events. This is a typical case of a rare cause of a common medical problem. A systematic approach to diagnosis and treatment of hyponatraemia in an oncology patient requires awareness of toxicities of systemic anticancer agents.<\/p>\n<p><a href=\"https:\/\/casereports.bmj.com\/content\/15\/3\/e248408\">Link to full-text<\/a> [NHS OpenAthens account required]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Type of publication: Journal article Author(s): *Parikh S; *Pettit L; *AbdelGadir H Citation: BMJ Case Reports, 2022 Mar 22; Vol. 15 Abstract: Two postmenopausal women with breast cancer developed acute confusion and seizures, less than 24 hours after the first<span class=\"ellipsis\">&hellip;<\/span><\/p>\n<div class=\"read-more\"><a href=\"https:\/\/www.library.sath.nhs.uk\/research\/2022\/05\/09\/severe-hyponatraemia-in-two-patients-with-breast-cancer-caused-by-low-dose-cyclophosphamide-and-precipitated-by-aprepitant-2022\/\">Read more <span class=\"screen-reader-text\">Severe hyponatraemia in two patients with breast cancer caused by low-dose cyclophosphamide and precipitated by aprepitant (2022)<\/span><span class=\"meta-nav\"> &#8250;<\/span><\/a><\/div>\n<p><!-- end of .read-more --><\/p>\n","protected":false},"author":12,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[200],"tags":[1017,245,256,353],"class_list":["post-6923","post","type-post","status-publish","format-standard","hentry","category-staff-publication","tag-1017","tag-breast-cancer","tag-chemotherapy","tag-oncology"],"_links":{"self":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/6923","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/comments?post=6923"}],"version-history":[{"count":4,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/6923\/revisions"}],"predecessor-version":[{"id":6936,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/6923\/revisions\/6936"}],"wp:attachment":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/media?parent=6923"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/categories?post=6923"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/tags?post=6923"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}