[由分泌血管活性肠肽的肿瘤引起的急性肾衰竭]

[Acute renal failure caused by VIP-secreting tumor].

作者信息

Lambertini D, Bottini E, Talassi E, Tarchini R, Gaetti L, Bellomi A

机构信息

U.O. di Nefrologia ed Emodialisi, Azienda Ospedaliera Carlo Poma, Mantova, Italy.

出版信息

G Ital Nefrol. 2003 Jul-Aug;20(4):419-22.

PMID:14523904

Abstract

A 74-year-old woman had secretory diarrhea, severe metabolic acidosis, hypokalemia, hypovolemia, and acute renal failure caused by a pancreatic vasoactive intestinal polypeptide (VIP)-secreting tumor. Vipoma is a rare neuroendocrine tumor. Morbidity and mortality are related to long-standing dehydration and electrolyte and acid-base disturbance resulting in acute renal failure. Diagnosis requires the documentation of large volumes of secretory diarrhea, elevated VIP plasma levels, and the localization of the VIP-secreting tumor. Metastases are present in 50% of patients at the time of diagnosis. Treatment includes correction of volume, electrolyte, and metabolic abnormalities; CVVH during ARF; pharmacotherapy to decrease gastrointestinal secretion; and surgical resection of the vipoma.

摘要

一名74岁女性因胰腺分泌血管活性肠肽（VIP）的肿瘤出现分泌性腹泻、严重代谢性酸中毒、低钾血症、血容量不足和急性肾衰竭。VIPoma是一种罕见的神经内分泌肿瘤。发病率和死亡率与长期脱水以及导致急性肾衰竭的电解质和酸碱紊乱有关。诊断需要记录大量分泌性腹泻、血浆VIP水平升高以及分泌VIP肿瘤的定位。50%的患者在诊断时已有转移。治疗包括纠正血容量、电解质和代谢异常；急性肾衰竭期间进行连续性静脉-静脉血液滤过（CVVH）；减少胃肠道分泌的药物治疗；以及手术切除VIPoma。