Cyclophosphamide-induced hyponatremia leading to status epilepticus in a breast cancer patient

BJMO - volume 17, issue 1, january 2023

E. Cassiers MD, N. Blockx MD, W. Teurfs MD


Cyclophosphamide (CP) is a well-known and extensively used immunosuppressive and antineoplastic agent. CP-induced hyponatremia remains an underestimated adverse event, although it can lead to severe complications and death. This case report describes the occurrence of life-threatening status epilepticus in a 74-year-old breast cancer patient due to CP-induced hyponatremia. The primary underlying mechanism seems to be impaired free water clearance, which is not influenced by ADH, but rather a direct effect of CP alkylating metabolites on the distal renal tubule. Future research is needed to further clarify the underlying pathophysiology and possible predisposing factors. Thorough monitoring of the patient’s hydration status and electrolytes until 48 hours after the first administration of CP seems strongly advisable.

(BELG J MED ONCOL 2023;17(1):27–30)

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Elevated CA-15.3 in a patient with megaloblastic anaemia: A red herring in breast cancer follow-up

BJMO - volume 16, issue 7, november 2022

M. Wyckmans BSc, S. Mignon MD, N. Blockx MD, D. Schrijvers MD, PhD


The cancer antigen 15.3 (CA-15.3) is an important tumour marker for the evaluation of patients with a history of breast cancer. An increase of CA-15.3 can be a sign of breast cancer recurrence and warrants further investigation. However, CA-15.3 is not specific and can be elevated in several oncological and benign conditions. This case describes a megaloblastic anaemia due to folic acid deficiency and elevated CA-15.3 in a patient with a history of breast cancer. No signs of breast cancer recurrence were found, and serum CA-15.3 levels normalised after supplementation of folic acid. Benign causes of CA-15.3 elevation should be considered when evaluating a patient with a history of breast cancer.

(BELG J MED ONCOL 2022;16(6):360–2)

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Bone complications in cancer patients

BJMO - volume 8, issue 1, march 2014

D. Schrijvers MD, PhD, A. Vandebroek MD, N. Blockx MD, F. van Fraeyenhove MD

Bone complications are frequently observed in cancer patients. They may be the result of the disease or due to the anticancer treatment. Osteoporosis is seen in up to 30% of cancer patients depending on tumor type and treatment and screening for osteoporosis is indicated in selected patients. It should be prevented by the use of calcium and vitamin D and exercising programs and, if present, should be adequately treated by drugs registered for the treatment of osteoporosis. Bone metastases are observed in up to 75% of metastatic cancer patients depending on the tumor type. Skeletal-related complications, occurring in 50–70% in patients with bone metastases, can be prevented and delayed by the use of bisphosphonates or denosumab. Prevention of the development of bone metastases has been shown by anti-tumor treatment while the role of modification of the micro-environment by bisphosphonates and denosumab needs further study.

(BELG J MED ONCOL 2014;8(1):3–8)


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