Table 3.

Relevant case reports – study summary

Author, year	Patient population	Interventions	Outcome	Author conclusion
Antonelli et al. 1993 29	A 59‐year‐old man Slight fever, dyspnoea, weight loss, asthenia and mental slowness	300 mg DMC twice daily for about 3 weeks Water restriction Hypertonic saline iv Corticosteroid treatment for 10 months	Patient developed phosphate diabetes after 4 days of DMC Progressive amelioration of the symptomatology and resolution of SIADH after DMC discontinuation and the start of corticosteroids	Phosphate diabetes may be related to selective DMC‐induced tubulopathy
Curtis et al. 2002 30	A 94‐year‐old man hospitalised following collapse Diagnosis of SIADH	300 mg DMC three times daily plus fluid restriction Nine days after admission, DMC increased to four times daily Metronizadole Benzydamine hydrochloride mouth washes	Fatal acute renal failure	Short‐term DMC can effectively control symptomatic HN but caution is required because of its potential nephrotoxicity Authors note a danger of dehydration in patients whose fluid intake has become compromised Authors suggest that had DMC been discontinued once the HN had resolved, the development of acute renal failure would have been avoided
Danovitch et al. 1978 31	Two patients: 1. A 51‐year‐old man with oat‐cell carcinoma of the lung. Diagnosis of SIADH 2. A 60‐year‐old‐man with 4‐week history of confusion and drowsiness. Diagnosis of SIADH	1. 1200 mg DMC daily plus cyclophosphamide 2. 1200 mg DMC daily	DMC treatment corrected HN and hypo‐osmolality, but was discontinued in both patients owing to deterioration of renal function	Potentially dangerous side effects exclude routine use of DMC Overall, DMC is effective in the treatment of SIADH, but has a potential to lead to a deterioration of renal function
Decaux et al. 1981 33	A 76‐year‐old man admitted to hospital because of grand mal seizures SIADH diagnosed	A single dose of DMC Water restriction Urea infusion iv Furosemide	Patient had severe gastric intolerance to DMC and the drug was stopped after the first dose	HN was controlled with furosemide after intolerance to DMC
Decaux et al. 1985 32	A 62‐year‐old woman Heavy smoker reporting weakness and memory loss Diagnosis of SIADH Oat‐cell carcinoma	300 mg DMC twice daily	DMC corrected HN but led to phosphate diabetes	Phosphate diabetes appeared after therapy with DMC and persisted for 3 months The augmentation in phosphate clearance was unrelated to serum sodium levels Phosphate diabetes was related to selective DMC‐induced renal toxicity
Heim et al. 1977 34	75‐year‐old woman, decline in general condition and pleural effusion (Two further cases not receiving DMC are reported)	DMC 1200 mg/day	HN was corrected by fluid restriction; addition of DMC resulted in increased fluid clearance, but the patient developed vomiting and diarrhoea on day 4 and DMC was stopped on day 7	DMC is a relatively non‐toxic antibiotic which was shown to be effective; however, treatment was interrupted on day 8 owing to vomiting and diarrhoea The dose of 1200 mg/day may have been too strong for this patient
Padfield et al. 1978 35	A 64‐year‐old man with SIADH following head injury and meningitis	300 mg DMC four times daily followed by 600 mg DMC four times daily Fixed fluid intake	600 mg DMC four times daily rapidly corrected all biochemical features of SIADH Acute renal failure was possibly induced by DMC On discontinuation of DMC normal renal function returned.	DMC corrected the biochemical abnormalities of SIADH Possible evidence of nephrotoxicity
Perks et al. 1976 36	A 61‐year‐old man with memory deficit Inoperable carcinoma diagnosed 7 months after original admission	600 mg DMC daily Fluid restriction	Treatment with DMC led to clinical and biochemical improvement	DMC is a safe and effective treatment that in this case allowed discharge from hospital This regimen may simplify outpatient management of other patients with this syndrome
Shimoda et al. 1986 (note, published in Japanese) 38	A 63‐year‐old woman hospitalised after losing consciousness; prior surgery for ruptured anterior artery Diagnosis of SIADH	900 mg/day DMC 16 mg/day dexamethasone	Patient became comatose and developed quadriplegia after rapid correction of serum sodium levels Patient died of septic shock after 12 months of hospitalisation	Computed tomography scans and brain stem auditory responses were indicative of ODS
Soudan and Qunibi, 2012 39	A 78‐year‐old woman with history of hypothyroidism, vitiligo, rheumatoid arthritis and early Alzheimer's dementia Hospitalised with severe HN diagnosed as secondary to SIADH.	300 mg DMC three times daily. Fluid restriction Normal saline infusion Furosemide Existing medication: Methotrexate Memantine HCL Mirtazapine Sulfamethoxazole and trimethoprim	Patient developed severe HN as a result of rigid fluid restriction and DMC therapy Serum sodium levels stabilised after discontinuation of DMC	DMC should be reserved for patients unable tolerate or unwilling to follow strict fluid restriction

DMC, demeclocycline; HN, hypernatraemia; iv, intravenous; ODS, osmotic demyelination syndrome; SIADH, syndrome of inappropriate antidiuretic hormone secretion.