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一名胰腺癌合并糖尿病酮症酸中毒患者因高凝状态导致猝死。

Sudden Death Due to Hypercoagulability in a Patient With Pancreatic Cancer and Diabetic Ketoacidosis.

作者信息

Park Esther, Petrovic Milenko T, Shah Nidal, Sharma Rahul

机构信息

Pathology, University of Arkansas for Medical Sciences, Little Rock, USA.

Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, USA.

出版信息

Cureus. 2025 Apr 28;17(4):e83152. doi: 10.7759/cureus.83152. eCollection 2025 Apr.

Abstract

Pancreatic cancer is a significant contributor to cancer-related mortality, with an increasing incidence linked to an aging population. A rare complication of pancreatic cancer is diabetic ketoacidosis (DKA), which arises from the tumor's impairment of insulin production. DKA can also present alongside other challenges such as malnutrition and hypercoagulability. This study describes a 67-year-old female patient with a past medical history of type 2 diabetes who presented with DKA and was later diagnosed with a pancreatic mass suggestive of malignancy. She developed multiple venous thrombi and subsequent pulmonary emboli, leading to sudden death. Autopsy revealed extensive occlusive thrombi and ischemic changes, emphasizing the potentially life-threatening interactions between DKA, malignancy-associated hypercoagulability, and metabolic derangements of pancreatic cancer. This study reinforces the need for careful monitoring and management of thrombotic events in patients with multiple comorbidities.

摘要

胰腺癌是癌症相关死亡的一个重要因素,其发病率上升与人口老龄化有关。糖尿病酮症酸中毒(DKA)是胰腺癌一种罕见的并发症,它源于肿瘤对胰岛素生成的损害。DKA还可能伴有其他问题,如营养不良和高凝状态。本研究描述了一名67岁女性患者,她有2型糖尿病病史,因DKA就诊,后来被诊断出胰腺肿物,提示为恶性肿瘤。她出现了多处静脉血栓及随后的肺栓塞,导致猝死。尸检发现广泛的闭塞性血栓和缺血性改变,强调了DKA、恶性肿瘤相关高凝状态以及胰腺癌代谢紊乱之间潜在的危及生命的相互作用。本研究强化了对患有多种合并症患者的血栓事件进行仔细监测和管理的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08cf/12119977/653e0e8c0fe2/cureus-0017-00000083152-i01.jpg

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