Hocker Nathaniel, Story Maria, Lerud Alysa, Kuppachi Sarat
Internal Medicine, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
Nephrology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
BMJ Case Rep. 2021 Jun 29;14(6):e242172. doi: 10.1136/bcr-2021-242172.
We present a 61-year-old Caucasian woman with endometroid carcinoma as well as a poorly differentiated adenocarcinoma who developed severe hypercalcaemia in the setting of an elevated intact parathyroid hormone. The patient was hospitalised twice for her condition. During her first hospitalisation, she was diagnosed with an endometroid carcinoma and hypercalcaemia. With medical management, she had a normal calcium level on discharge. She presented 3 weeks later with hypercalcaemia and encephalopathy. This time her hypercalcaemia was refractory to medical management, and required continuous renal replacement therapy (CRRT) to normalise her serum calcium. Lung biopsy revealed a poorly differentiated adenocarcinoma, suspicious for pancreatic primary. Due to her poor prognosis, rapid elevation of calcium with each attempt to discontinue CRRT, and the poor options for treatment of her cancers, she elected to pursue hospice care.
我们报告了一位61岁的白种女性，她患有子宫内膜样癌以及低分化腺癌，在甲状旁腺激素水平升高的情况下出现了严重的高钙血症。该患者因病情两次住院。在她的第一次住院期间，她被诊断出患有子宫内膜样癌和高钙血症。经过药物治疗，她出院时血钙水平正常。3周后，她因高钙血症和脑病再次就诊。这次她的高钙血症对药物治疗无效，需要持续肾脏替代治疗（CRRT）来使血清钙恢复正常。肺部活检显示为低分化腺癌，怀疑原发于胰腺。由于她预后较差，每次尝试停止CRRT时血钙都会迅速升高，且治疗其癌症的选择有限，她选择接受临终关怀。
