Use of SGLT 2 inhibition in the management of hyponatremia in a patient with metastatic cancer

Abstract

Hyponatremia is a common electrolyte abnormality in patients with malignancy, and recent investigations into the off-label use of SGLT₂ inhibitors for syndrome of inappropriate antidiuretic hormone (SIADH) have shown promising short-term results. We report the case of an 84-year-old woman with history of relapsed metastatic uterine carcinosarcoma with chronic hyponatremia who failed standard therapy. The patient was initiated on empagliflozin 11 months ago and has had sustained normalization of serum sodium levels. While less is known about the long-term use of these agents, this case highlights the potential for SGLT₂ inhibitors to be used as a low-burden therapeutic option for cancer-associated chronic hyponatremia.