Division of Internal Medicine, University General Hospital of Patras, Patras, Greece.
Ann Clin Biochem. 2014 Jan;51(Pt 1):101-5. doi: 10.1177/0004563213500658. Epub 2013 Sep 18.
We hereby describe the rare case of a 59-year-old patient presenting with marked hyperamylasaemia mimicking acute pancreatitis upon admission. Investigation of co-existent hypokalemia revealed the presence of ectopic adrenocorticotropic hormone secretion, leading to the final diagnosis of small cell lung cancer, exhibiting dual paraneoplastic syndromes including Cushing Syndrome and hyperamylasaemia. Although, paraneoplastic syndromes occur commonly, paraneoplastic hyperamylasaemia especially in the context of dual paraneoplastic syndromes occurring simultaneously, is extremely rare. Such misleading manifestations require a high index of suspicion on behalf of the physician, so that an underlying malignancy is not missed, and a final diagnosis combining all clinical and laboratory findings is reached. In turn, in rare cases common biochemical markers such as amylase can be used as a useful follow up index driving further management.
我们在此描述了一例罕见病例，一名 59 岁患者因入院时表现为明显的高淀粉酶血症而类似急性胰腺炎。对并存的低钾血症的检查发现异位促肾上腺皮质激素分泌，最终诊断为小细胞肺癌，表现出包括库欣综合征和高淀粉酶血症在内的双重副肿瘤综合征。尽管副肿瘤综合征很常见，但副肿瘤性高淀粉酶血症，特别是在同时发生双重副肿瘤综合征的情况下，极为罕见。这种误导性表现需要医生高度怀疑，以避免遗漏潜在的恶性肿瘤，并根据所有临床和实验室发现做出最终诊断。反过来，在罕见情况下，常用的生化标志物如淀粉酶可以作为有用的随访指标，指导进一步的治疗。
