Year: 2018
Type: article
Study design: Case Report
Abstract: Cyclophosphamide has become a cornerstone of breast cancer therapy in the neo-adjuvant, adjuvant, and metastatic setting.Common side effects of cyclophosphamide include myelosuppression, nausea, emesis, diarrhea, and alopecia.A less common side effect of cyclophosphamide is hyponatremia.Hyponatremia is more commonly associated with high-dose cyclophosphamide.We describe two cases of severe hyponatremia after low-dose cyclophosphamide infusion in patients with breast cancer.The first case involved a 56-year-old female receiving neo-adjuvant chemotherapy with doxorubicin 60 mg/m 2 and cyclophosphamide 600 mg/m 2 for early-stage breast cancer.Medications were notable for clonazepam, ondansetron, prochlorperazine, tramadol, and zolpidem.The day following her second cycle of chemotherapy, the patient was found to have a witnessed seizure.Laboratories revealed a serum sodium of 116 mmol/L, serum osmolality 253 mOsm/L, urine osmolality 273 mOsm/kg, and urine sodium 49 mmol/L.While in the Emergency Center, the patient was noted to have a seizure and was intubated.Hypertonic saline was initiated.EEG was notable for generalized slowing, and MRI brain showed no evidence of metastatic disease or ischemia.Over 3 days, the patient's sodium improved and she was extubated.The patient's Adjuvant 43 112 Seizure
Source: The Breast Journal
DOI: 10.1111/tbj.13026
Authors: Katherine Clifton, Chad Barnett, Ashley Martinez, Meghan Karuturi, Sadia Saleem, Jennifer Litton
Institution: The University of Texas MD Anderson Cancer Center
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funder: National Cancer Institute
OpenAlex ID: W2789836934