HYPONATREMIC ENCEPHALOPATHY AS THE INITIAL SIGN OF NEUROENDOCRINE SMALL CELL CARCINOMA: CASE REPORT

摘要

Background. Small-cell lung carcinoma is a neuroendocrine tumor that exhibits aggressive behavior, rapid growth, early spread to distant sites and frequent association with paraneoplastic syndromes, the most frequent being the syndrome of inappropriate secretion of antidiuretic hormone (SIADH).Case report. We present the case of a 66 year-old woman who presented to the Emergency Department for a syncope preceded by vomiting. She had one-month history of progressive confusion, disorientation, drowsiness, and generalized malaise. At presentation, the biochemical profile showed normal hemogram values, severe hyponatremia (seric sodium level 120 mg/dL), low plasma osmolality (<275 mOsm/ kg). The blood tests for kidney, thyroid and adrenal functions were in normal limits. There was no evidence of congestive heart failure or nephrotic syndrome.