pituitrin and Lymphoma--Non-Hodgkin

Some days after the administration of a third bolus of ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) a patient affected by immunoblastic lymphoma underwent a neurotoxic crisis. The episode lasted 1 week and was followed by a dramatic fall in plasma sodium (104 mEq I-1), associated with a proportionally lesser decrease in plasma chloride and phosphate. Despite the lowest plasma osmolality, detectable levels of circulating ADH were present. After 36 h the hyponatremic episode improved after the infusion of hypertonic sodium chloride. Nevertheless the patient lapsed into a hypotonic coma. The urinary concentrations of the main tubular enzymes (gamma-glutamyltranspeptidase, N-acetyl-glucosaminidase, alpha-glucosidase) proved very high and successively decreased slowly. The most likely cause of such hyponatremic episode is vinblastine. The drug acted through: (a) an already known inappropriate release of ADH, and (b) a hitherto unreported tubular lesion, which impaired the reabsorption of sodium and other coupled solutes.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Dacarbazine; Doxorubicin; Female; Humans; Hyponatremia; Kidney Tubules; Lymphoma, Non-Hodgkin; Vasopressins; Vinblastine; Vincristine

Topics: Hormones, Ectopic; Humans; Lymphoma, Non-Hodgkin; Male; Middle Aged; Vasopressins

Topics: Adult; Carcinoma, Bronchogenic; Cryptococcosis; Granuloma; Hormones, Ectopic; Humans; Hypercalcemia; Lung Diseases; Lung Diseases, Fungal; Lymph Nodes; Lymphoma, Non-Hodgkin; Male; Nephrocalcinosis; Radiography, Thoracic; Vasopressins

Topics: Aged; Humans; Hyponatremia; In Vitro Techniques; Lymphoma, Non-Hodgkin; Male; Mediastinal Neoplasms; Vasopressins