Greco A V, Bertoli A, Caputo S, Caradonna P, Barone C, Grieco A
Acta Diabetol Lat. 1985 Jan-Mar;22(1):73-7. doi: 10.1007/BF02591095.
A diabetic patient presented with weight loss, ketosis, and hyperventilation, thus mimicking the clinical picture of diabetic ketoacidosis. Laboratory investigations revealed alkalemia and a pattern consistent with a triple derangement of acid-base equilibrium: respiratory alkalosis, metabolic acidosis and metabolic alkalosis. High cortisol level suggested a genesis of ketosis different from diabetes mellitus. The patient died suddenly from acute gastrointestinal bleeding. Autopsy showed a carcinoma of the head of the pancreas with secondary portal hypertension and rupture of varices. Pulmonary micrometastases were demonstrated. It is suggested that stress hormones were the main cause of the 'ketoalkalotic' pattern observed.
一名糖尿病患者出现体重减轻、酮症和呼吸急促，从而酷似糖尿病酮症酸中毒的临床表现。实验室检查显示碱血症以及与酸碱平衡三重紊乱相符的模式：呼吸性碱中毒、代谢性酸中毒和代谢性碱中毒。高皮质醇水平提示酮症的发生与糖尿病不同。患者因急性胃肠道出血突然死亡。尸检显示胰腺头部癌伴继发性门静脉高压和静脉曲张破裂。发现有肺微转移。提示应激激素是所观察到的“酮性碱中毒”模式的主要原因。
