Abstract
A 40-year-old woman with lung cancer had multiple episodes of hyponatremia when- ever she had chemotherapy with cisplatin plus etoposide and/or carboplatin plus etoposide over the last year. Although she had been diagnosed as having Syndrome of Inappropriate Secre- tion of Antidiuretic Hormone (SIADH), based on a multidisciplinary assessment, a diagnosis of Renal Salt Wasting Syndrome (RSWS) possibly due to carboplatin was made, and after completion of intravenous treatment with isotonic saline, hyponatremia resolved, and she was discharged uneventfully. Cisplatin is well known for causing renal toxicity via proximal tubu- lar damage, some cases of which present as RSWS. However, RSWS is extremely rare with carboplatin. The differential diagnosis between RSWS and SIADH for hyponatremic patients is sometimes difficult because of similarities in their clinical features, but careful consideration is needed to make the correct diagnosis because their treatments are diametrically opposed.
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