与纤维板层型肝细胞癌相关的高氨血症性脑病：病例报告、文献综述及建议的治疗方案
Hyperammonemic Encephalopathy Associated With Fibrolamellar Hepatocellular Carcinoma: Case Report, Literature Review, and Proposed Treatment Algorithm.
作者信息
Chapuy Claudia I, Sahai Inderneel, Sharma Rohit, Zhu Andrew X, Kozyreva Olga N
机构信息
Dana-Farber Cancer Institute at St. Elizabeth's Medical Center, Boston, Massachusetts, USA.
Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
出版信息
Oncologist. 2016 Apr;21(4):514-20. doi: 10.1634/theoncologist.2015-0267. Epub 2016 Mar 14.
Abstract
UNLABELLED
We report a case of a 31-year-old man with metastatic fibrolamellar hepatocellular carcinoma (FLHCC) treated with gemcitabine and oxaliplatin complicated by hyperammonemic encephalopathy biochemically consistent with acquired ornithine transcarbamylase deficiency. Awareness of FLHCC-associated hyperammonemic encephalopathy and a pathophysiology-based management approach can optimize patient outcome and prevent serious complications. A discussion of the management, literature review, and proposed treatment algorithm of this rare metabolic complication are presented.
IMPLICATIONS FOR PRACTICE
Pathophysiology-guided management of cancer-associated hyperammonemic encephalopathy can improve patient outcome and prevent life-threatening complications. Community and academic oncologists should be aware of this serious metabolic complication of cancer and be familiar with its management.
摘要
未标注
我们报告了一例31岁转移性纤维板层型肝细胞癌（FLHCC）男性患者，接受吉西他滨和奥沙利铂治疗，并发高氨血症性脑病，生化检查结果与获得性鸟氨酸转氨甲酰酶缺乏症相符。认识到FLHCC相关的高氨血症性脑病以及基于病理生理学的管理方法可优化患者预后并预防严重并发症。本文对这种罕见代谢并发症的管理、文献综述及建议的治疗算法进行了讨论。
对实践的启示
以病理生理学为导向管理癌症相关的高氨血症性脑病可改善患者预后并预防危及生命的并发症。社区和学术肿瘤学家应了解这种严重的癌症代谢并发症并熟悉其管理方法。
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