An electron microscopic study of the effects of vinblastine sulphate on the ultrastructure of the kidney, trachea, liver, peripheral nerve and small intestine of the rat

Syndrome of Inappropriate Antidiuretic Hormone Secretion Associated with Hepatic Arterial Infusion of Vinblastine in Three Patients with Breast Cancer

We report the occurrence of the syndrome of inappropriate antidiuretic hormone secretion in 3 patients with breast carcinoma metastatic to the liver who received hepatic arterial infusion of vinblastine at lower doses than those previously associated with this effect. Leukopenia was severe in all patients, who additionally experienced hypokalemia with excessive kaliuresis. The etiology of the observed hypokalemia is unclear. We suspect that vinblastine may induce renal tubular dysfunction. These toxicities appear dose-related.

Syndrome of inappropriate antidiuretic hormone associated with vinorelbine therapy

OBJECTIVE

To describe onset of syndrome of inappropriate antidiuretic hormone (SIADH) associated with vinorelbine therapy for advanced breast cancer.

CASE SUMMARY

A 50-year-old white woman with a history of advanced breast cancer refractory to other treatment modalities was receiving vinorelbine. Blood chemistries revealed severely depleted sodium and potassium concentrations from a normal baseline within a 7-day period. A recheck of blood chemistries confirmed hyponatremia. The patient was admitted to the hospital and treated for SIADH. After successful treatment, she was given demeclocycline prophylactically and rechallenged with vinorelbine without recurrence of the syndrome.

DISCUSSION

SIADH has been reported as a complication of treatment with vinca alkaloids. To our knowledge, this is the first report of this syndrome related to vinorelbine therapy.

CONCLUSIONS

Because of its structural similarity to the other vinca alkaloids, vinorelbine is believed to be responsible for SIADH in our patient. Clinicians should be aware of the possibility that vinorelbine may cause SIADH and possibly hypokalemia.