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Discussions In our case, we identified at least 4 possible causes of SIADH and hyponatremia: i Glossopharyngeal squamous cell carcinoma ii Cisplatin treatment iii Right basal pneumonia with Pseudomonas aeruginosa iv The treatment with LevofloxacinEach of these etiological factors will be discussed separately beneath.

The development of hyponatremia, during cisplatin therapy, bears special mention for our case.

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A recent German study reported a high incidence of hyponatremia 31. However, the association of these comorbidities with sodium levels was weak and disappeared after inclusion in a multivariate model.

The relationship of hyponatremia and higher pneumonia severity probably reflects the presence of hypovolemia, severe sepsis, and subsequent activation of vasopressin and natriuretic peptides secretion.

The decrease in the ability to reduce urine osmolality and excrete water loads and the increasing levels of ADH in the absence of antibiotic treatment might be incriminated in pneumonia-induced hyponatremia.

An objective causality assessment using the Naranjo scale could have been useful to demonstrate the link between Levofloxacin use and hyponatremia.

Case Reports in Medicine

Finally, the link between alcohol ingestion and hyponatremia is worth mentioning. The mechanisms for hyponatremia in alcoholics include hypovolemia, pseudohyponatremia due to alcohol-induced hypertriglyceridemia, beer potomania syndrome, and rarely SIADH or cerebral salt wasting.

In our case, heteroanamnesis revealed the stop of alcohol ingestion 1 year prior to presentation, so chronic alcoholism was not considered as a cause of hyponatremia. Conclusions In summary, we presented a case of hyponatremia of multifactorial etiology that was promptly investigated and corrected.

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During the acute episode of pneumonia and Levofloxacin treatment, hyponatremia suddenly aggravated and the patient became symptomatic neck cancer. Looking back into his past medical file, as shown in Figure 1, we discovered that our patient had been hyponatremic ever since diagnosed with.

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Case Reports in Medicine

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An half causality assessment using the Naranjo young could have been useful to know the link between Levofloxacin taste and hyponatremia.

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