Cisplatin-induced Severe Renal Salt-wasting Syndrome Complicated with Hypovolemic Shock and Various Electrolyte Abnormalities in a Patient with Thymoma

Renal salt-wasting syndrome (RSWS) induced by cisplatin causes hyponatremia and dehydration. A 75-year-old woman with thymoma underwent cisplatin chemotherapy. She presented with hypovolemic shock, seizures, and impaired consciousness (Japan Coma Scale II-30) with a decreased serum sodium level of 116 mmol/L on day 9. In addition, the patient had hypokalemia, hypomagnesemia, hypocalcemia, and hypophosphatemia. We herein describe the first reported case of RSWS complicated by hypovolemic shock. This is the second reported case with multiple electrolyte abnormalities. Thus, we should recognize that severe RSWS with hypovolemic shock and multiple electrolyte abnormalities can occur in patients undergoing cisplatin treatment.