Beyond the Dual Paraneoplastic Syndromes of Small-Cell Lung Cancer with ADH and ACTH Secretion: A Case Report with Literature Review and Future Implications

Table 1

Some important laboratory results. D stands for day. Patient passed away on D78.

Test	Initial office visit (D0)	After the onset of EAS (D47)	Chemotherapy day 1 of 3 (D53)	Postchemo day 8 (D63)	MICU admission (D72)	Comfort measures initiated (D77)
Hemoglobin (g/dl)	12.7	12.9	8.6	8.5	8.2	6.7
Hematocrit (%)	35.1	37.9	25.4	24.4	24.3	20.1
WBC (10^3/mm^3)	7.4	19.4	14.7	0.3	20.6	16.3
Platelet count (10^3/mm^3)	255	200	168	23	366	379
Sodium (mEq/l)	126	135	128	134	139	138
Potassium (mEq/l)	4.3	2.8	4.4	3.3	4.1	5.3
Chloride (mEq/l)	83	76	84	87	92	97
Bicarbonate (mEq/l)	28	45	34	34	37	29
Anion gap (mEq/l)	15	14	10	13	10	12
Glucose (mg/dl)	82	98	111	118	127	131
BUN (mg/dl)	11	11	27	9	11	10
Creatinine (mg/dl)	0.6	0.5	0.6	0.5	0.5	0.5
S. osm (mOsm/kg)	260
Calcium (mEq/l)	9	9				Ical—1.27
AST (U/l)	25			17		14
ALT (U/l)	18			33		20
T. bilirubin (mg/dl)	0.3			0.4		0.1
Troponin (ng/ml)	0.01
ACTH (pg/ml)		319	265	399
Cortisol (μg/dl)	7.1	131.5		164.4	138.5	134.7
TSH (mIU/l)	0.88
PRA		<0.15
Aldosterone (ng/dl)		<1.0
Epinephrine (pg/ml)					47
Norepinephrine (pg/ml)					1004
Dopamine (pg/ml)					126
DHEA sulfate (μg/dl)			60