[严重乳酸酸中毒揭示血液系统恶性肿瘤]

[Severe lactic acidosis revealing hematologic malignancy].

作者信息

Ouchikhe A, Le Bivic J-L, Longuet O, Maindivide J, Vincent J-F

机构信息

Service de réanimation polyvalente, centre hospitalier Saintonge, 11, boulevard Ambroise-Paré, 17100 Saintes, France.

出版信息

Ann Fr Anesth Reanim. 2014 Jun;33(6):430-2. doi: 10.1016/j.annfar.2014.05.005. Epub 2014 Jun 10.

DOI:10.1016/j.annfar.2014.05.005

PMID:24927632

Abstract

A 75-year-old woman is hospitalised for sepsis. The diagnosis of cholecystitis is made and an antibiotic therapy is debuted. The clinical worsening leads to realise an urgent cholecystectomy. A sepsis like shock persisted. The antibiotherapy was changed and a second abdominal look made. A severe lactic acidosis persisted since the cholecystectomy despite a continuous hemofiltration. The diagnosis of type B lactic acidosis secondary to malignancy was suspected. An osteomedullar biopsy revelled B-cell lymphoma EBV induced.

摘要

一名75岁女性因败血症住院。诊断为胆囊炎并开始抗生素治疗。临床病情恶化导致进行紧急胆囊切除术。败血症样休克持续存在。更换了抗生素治疗方案并再次进行腹部检查。尽管进行了持续血液滤过，但自胆囊切除术后严重乳酸酸中毒仍持续存在。怀疑是继发于恶性肿瘤的B型乳酸酸中毒。骨髓活检显示为EB病毒诱导的B细胞淋巴瘤。