SWEET TASTE (DYSGEUSIA) - THE FIRST SYMPTOM OF HYPONATREMIA IN SMALL-CELL CARCINOMA OF THE LUNG

Three patients with small cell carcinoma of the lung presented with a persistent unpleasant sweet taste as their initial and only symptom. O n further evaluation, they were found to have hyponatremia secondary t o the syndrome of inappropriate secretion of antidiuretic hormone. In each case, resolution of the sweet taste paralled an increase in serum sodium concentration after water restriction alone. Linkage of the sw eet taste with a low serum sodium concentration strongly implicates hy ponatremia-rather than tumor, antidiuretic factor, medications, or che motherapy-as the central mechanism responsible for this previously unr eported (to our knowledge) sentinel symptom of small cell carcinoma of the lung.