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Syndrome of Inappropriate Antidiuresis in Small-Cell Lung Cancer

Classification and Effect of Tumor Regression

Authors

  • JENS BENN SØRENSEN,

    Corresponding author
    1. Department of Oncology ONB, Finsen Institute, the Department of Internal Medicine C, Bispebjerg Hospital, and the Department of Internal Medicine P, Division of Nephrology, Rigshospitalet, Copenhagen, Denmark
      Department of Oncology ONB, Finsen Institute, 49 Strand-boulevarden, DK-2100 Copenhagen, Denmark
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  • PAUL E. G. KRISTJANSEN,

    1. Department of Oncology ONB, Finsen Institute, the Department of Internal Medicine C, Bispebjerg Hospital, and the Department of Internal Medicine P, Division of Nephrology, Rigshospitalet, Copenhagen, Denmark
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  • KELL ØSTERLIND,

    1. Department of Oncology ONB, Finsen Institute, the Department of Internal Medicine C, Bispebjerg Hospital, and the Department of Internal Medicine P, Division of Nephrology, Rigshospitalet, Copenhagen, Denmark
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  • MOGENS HAMMER,

    1. Department of Oncology ONB, Finsen Institute, the Department of Internal Medicine C, Bispebjerg Hospital, and the Department of Internal Medicine P, Division of Nephrology, Rigshospitalet, Copenhagen, Denmark
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  • MOGENS HANSEN

    1. Department of Oncology ONB, Finsen Institute, the Department of Internal Medicine C, Bispebjerg Hospital, and the Department of Internal Medicine P, Division of Nephrology, Rigshospitalet, Copenhagen, Denmark
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Department of Oncology ONB, Finsen Institute, 49 Strand-boulevarden, DK-2100 Copenhagen, Denmark

Abstract

ABSTRACT Patients with small-cell lung cancer and hyponatremia were examined for the syndrome of inappropriate antidiuresis (SIAD). A comparison was made between the definition based on hyponatremia, serum hypoosmolality and urine hyperosmolality (classic SIAD, 12 patients) and a definition based on measurement of plasma ADH concentration by radioimmunoassay (RIA-SIAD, nine patients) and patients without SIAD (eight patients). A standard water load test was performed as a reference before initiation of cytostatic treatment. All tests were repeated if remission of the malignant disease occurred. RIA-SIAD patients were a subgroup of classic SIAD patients, with more pronounced homeostatic abnormalities. Biochemical abnormalities were reduced after tumor regression but a completely normal renal water handling was achieved in only few patients, even when complete remission of the tumor was achieved, presumably due to the persistence of subclinical disease. However, an effect of other yet unknown factors might be of influence.

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