Saleh Ramy R, Rodrigues Jennifer, Lee Todd C
Department of Internal Medicine, McGill University, Montreal, Canada.
BMJ Case Rep. 2015 Jan 29;2015:bcr2014207748. doi: 10.1136/bcr-2014-207748.
A 56-year-old woman with a new diagnosis of metastatic pancreatic cancer presents to the emergency room with generalised fatigue. The patient is afebrile, however, hypotensive and tachycardic. Physical examination shows diffuse lymphadenopathy. Initial laboratory tests indicate that the patient has hyperkalaemia, hypocalcaemia, with a high lactate dehydrogenase and high uric acid. The patient was also in renal failure. On the basis of the clinical presentation, the patient was diagnosed with spontaneous tumour lysis syndrome, despite the syndrome never having been reported in metastatic pancreatic cancer. The patient was treated appropriately with intravenous hydration, allopurinol and rasburicase. All laboratory abnormalities were corrected by day 3 of treatment.
一名新诊断为转移性胰腺癌的56岁女性因全身乏力就诊于急诊室。患者无发热，但血压低且心动过速。体格检查发现全身淋巴结肿大。初步实验室检查表明患者存在高钾血症、低钙血症，乳酸脱氢酶和尿酸水平升高。患者还出现了肾衰竭。根据临床表现，尽管该综合征从未在转移性胰腺癌中报道过，但该患者仍被诊断为自发性肿瘤溶解综合征。患者接受了静脉补液、别嘌醇和拉布立酶的适当治疗。治疗第3天时，所有实验室异常均得到纠正。
