Krug S, Michl P
Klinik für Innere Medizin I, Martin-Luther-Universität Halle/Wittenberg, Ernst-Grube-Str. 40, 06114, Halle (Saale), Deutschland.
Internist (Berl). 2018 Feb;59(2):114-124. doi: 10.1007/s00108-017-0357-2.
Paraneoplastic syndromes are characterized by the tumor-induced release of peptide hormones and/or the initiation of immune phenomena, which elicit clinical changes and alterations in laboratory parameters independent of the tumor size and spread. In addition to neurological, endocrinal and rheumatological phenotypes, metabolic alterations play a special role in the clinical routine as they commonly present with acute symptoms in an emergency situation and necessitate immediate diagnosis and prompt initiation of treatment. Metabolic alterations within the framework of malignant diseases should be treated in a multidisciplinary team and it is often necessary to perform monitoring and treatment in an intensive care unit. This article focuses on the diagnostic and therapeutic options for metabolic disorders due to paraneoplastic syndromes, such as hypercalcemia, hypocalcemia, hyperglycemia, hypoglycemia and a special variant of tumor-induced metabolic disorders due to tumor lysis syndrome.
副肿瘤综合征的特征是肿瘤诱导肽类激素释放和/或引发免疫现象，从而导致临床变化和实验室参数改变，且这些改变与肿瘤大小和扩散无关。除神经、内分泌和风湿性表型外，代谢改变在临床实践中具有特殊作用，因为它们通常在紧急情况下表现为急性症状，需要立即诊断并迅速开始治疗。恶性疾病框架内的代谢改变应由多学科团队进行治疗，且通常有必要在重症监护病房进行监测和治疗。本文重点关注副肿瘤综合征所致代谢紊乱的诊断和治疗选择，如高钙血症、低钙血症、高血糖、低血糖以及肿瘤溶解综合征所致肿瘤诱导代谢紊乱的一种特殊变体。
