Marsalisi Christopher B, Zhang Yixin, Sousou John M, Lam Loruanma, Burstiner Landen S, Ferreira Jason, Najjar Nimeh
Internal Medicine, University of Florida College of Medicine, Jacksonville, USA.
Cardiology, University of Florida College of Medicine, Jacksonville, USA.
Cureus. 2024 Sep 11;16(9):e69193. doi: 10.7759/cureus.69193. eCollection 2024 Sep.
A 67-year-old female presented with abdominal pain, nausea, vomiting, and unintentional weight loss. Further work-up revealed elevated serum cortisol, hypokalemia, and metabolic alkalosis in the setting of paraneoplastic Cushing's syndrome secondary to small lung cancer. The patient then developed refractory convulsive epileptic seizure despite being on multiple anti-epileptic medications. Here, we present a unique case where continuous etomidate infusion was used to lower serum cortisol, as adrenal insufficiency is associated with etomidate use. This case emphasizes how drug side effects can be used to achieve a desired treatment outcome.
一名67岁女性出现腹痛、恶心、呕吐和非故意体重减轻。进一步检查发现，在继发于小肺癌的副肿瘤性库欣综合征背景下，血清皮质醇升高、低钾血症和代谢性碱中毒。尽管患者服用了多种抗癫痫药物，但仍出现难治性惊厥性癫痫发作。在此，我们报告一例独特病例，即使用依托咪酯持续输注来降低血清皮质醇，因为使用依托咪酯会导致肾上腺功能不全。该病例强调了药物副作用如何可被用于实现预期的治疗效果。
