低钙血症揭示了一种肠病相关的T细胞淋巴瘤。
Hypocalcemia Revealing an Enteropathy-Associated T-cell Lymphoma.
作者信息
Alonso Ortiz Maria Belen, Villalba Noel Lorenzo, Marroquin Emilio Almaraz, Kechida Melek, Mendez-Bailon Manuel, Gonzalez Imanol Pulido
机构信息
Department of Internal Medicine, Gran Canaria University Hospital, Las Palmas, Spain.
Department of Internal Medicine, Chretien Hospital, Liege, Belgium.
出版信息
Caspian J Intern Med. 2019 Winter;10(1):111-117. doi: 10.22088/cjim.10.1.111.
BACKGROUND
Enteropathy-associated T-cell lymphoma (EATL) is a rare and aggressive type of extranodal T-cell lymphoma (TCL) arising in the gastrointestinal (GI) tract and represents 5-8% of all T-cell non-Hodgkin lymphomas (NHL) and 10-25% of primary intestinal lymphomas.
CASE PRESENTATION
We reported a 78-year-old woman presenting with severe hypocalcemia. Investigations confirmed vitamin D and iron deficiency as well as hypoalbuminemia. Celiac disease was suspected and confirmed, but despite intravenous calcium and magnesium supplementation and a gluten-free diet, normal electrolyte levels were never reached. Intestinal perforation was the clue to the diagnosis of enteropathy-associated T-cell lymphoma (EATL).
CONCLUSION
Hypocalcemia can result from multiple conditions. In patients not responding to adequate supplementation, further investigations should be performed to diagnose the underlying condition.
背景
肠病相关T细胞淋巴瘤（EATL）是一种罕见且侵袭性的结外T细胞淋巴瘤（TCL），发生于胃肠道，占所有T细胞非霍奇金淋巴瘤（NHL）的5 - 8%，原发性肠道淋巴瘤的10 - 25%。
病例报告
我们报告了一名78岁女性，表现为严重低钙血症。检查证实维生素D和铁缺乏以及低白蛋白血症。怀疑并确诊为乳糜泻，但尽管静脉补充钙和镁并采用无麸质饮食，电解质水平仍未恢复正常。肠道穿孔是诊断肠病相关T细胞淋巴瘤（EATL）的线索。
结论
低钙血症可由多种情况引起。对于补充治疗无反应的患者，应进行进一步检查以诊断潜在疾病。
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