Small cell carcinoma of the cervix with syndrome of inappropriate antidiuretic hormone secretion following chemotherapy: A case report and literature review
Bibliographic record
Abstract
• We present a case of severe hypanetremia secondary to SIADH in cervical small cell carcinoma. • The cause of SIADH may be due to cisplatin, but this persisted despite change to carboplatin. • Prophylactic tolvaptan may prevent the recurrence of hyponatremia. • Disease recurrence at 7 months was treated with carboplatin, etoposide and durvalumab, without evidence of hyponatremia. • Severe hyponatremia and SIADH mostly occurs early in the disease course, with minimal risk of recurrence. This report aims to present a rare case of severe hyponatremia induced by syndrome of inappropriate antidiuretic hormone secretion (SIADH) following chemotherapy in a patient with small cell carcinoma of the cervix (SCCC). It also reviews the existing literature on this rare phenomenon. A 45-year-old female with SCCC developed acute symptomatic hyponatremia (sodium level 110 mmol/L) three days following cisplatin-based chemotherapy. SIADH was diagnosed, and the patient required intubation and admission to the intensive care unit due to severe agitation and confusion. Despite initial correction of sodium levels, the patient developed recurrent hyponatremia after subsequent chemotherapy cycles that was refractive to first line agents. She required the use of Tolvaptan, a vasopressin type 2 receptor antagonist, for the management of hyponatremia. This case highlights the rare occurrence of severe SIADH in a patient with SCCC, underscoring the complexity of managing electrolyte disturbances in the context of both paraneoplastic syndromes and chemotherapeutic side effect. The severity of our patient’s presentation calls attention to the importance of early recognition of SIADH in the differential diagnosis of oncology patients with altered mental status and confusion. Post chemotherapy sodium surveillance could lead to improved patient outcomes, as well as monitoring for signs and symptoms of hyponatremia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".