SYNDROME OF INAPPROPRIATE SECRETION OF ANTIDIURETIC-HORMONE IN NASOPHARYNX CARCINOMA

The syndrome of inappropriate secretion of antidiuretic hormone (ADH o r SIADH has been reported in various disorders, We report a pediatric patient with nasopharynx carcinoma who ma!: have developed a clinical SIADH with severe hyponatremia and generalized seizure during the admi nistration of intravenous hydration. We propose that the inappropriate ly high plasma level of ADH led to the inability to excrete sufficient amounts of free water during a hyperhydration protocol with a relativ ely hypotonic fluid, which resulted in acute hyponatremia and central nervous system involvement. To avoid this complication, intravenous hy dration before chemotherapy in children with nasopharynx carcinoma sho uld be performed at a slower infusion rate and with a sodium chloride concentration of more than half isotonic.