揭开一名 59 岁 B 细胞淋巴瘤女性患者低钙血症和乳酸酸中毒的致命之舞。

Q3 Medicine
European journal of case reports in internal medicine Pub Date : 2024-06-27 eCollection Date: 2024-01-01 DOI:10.12890/2024_004643
Yasaman Navari, Efosa Bazuaye, Philip J McDonald
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引用次数: 0

摘要

钙在心脏电传导系统和促进心肌收缩方面起着至关重要的作用。低钙血症可导致心电图结果,如QTC间期延长,最终出现心搏过速,严重时可导致心脏骤停。在 B 细胞淋巴瘤病例中,低钙血症可能由多种因素引起。肿瘤浸润会影响甲状旁腺或骨组织,从而破坏钙的稳态。B 细胞淋巴瘤引起的酸中毒会对心血管产生严重的不良影响。它会降低外周血管阻力和心肌收缩力,促进心律失常,并干扰肺部摄氧。这些综合效应会明显损害心脏功能,增加心脏骤停的可能性。这些机制要求对 B 细胞淋巴瘤患者采取综合管理策略。在本病例报告中,我们介绍了一例继发于 B 细胞淋巴瘤的低钙血症和乳酸酸中毒的 59 岁女性心脏骤停病例:学习要点:B 细胞淋巴瘤的乳酸酸中毒可由多种因素引起。B 细胞淋巴瘤患者可能继发于肿瘤溶解综合征、副肿瘤综合征或继发于治疗的低钙血症,在癌症患者心跳骤停时应始终考虑这些可逆的原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Unveiling the Deadly Dance of Hypocalcemia and Lactic Acidosis in a 59-Year-Old Woman with B-Cell Lymphoma.

Calcium plays a crucial role in the heart's electrical conduction system and facilitating the contraction of cardiac muscles. Hypocalcemia can result in electrocardiogram findings such as a prolonged QTC interval and eventually torsade de pointes, which in severe cases can progress to cardiac arrest. In cases of B-cell lymphoma, hypocalcemia may arise from various factors. Tumor infiltration can disrupt calcium homeostasis by affecting the parathyroid glands or bone tissue. Acidosis in the context of B-cell lymphoma can cause significant cardiovascular adverse effects. It will reduce peripheral vascular resistance and cardiac muscle contractility, promote dysrhythmias, and disturb oxygen uptake in the lungs. These combined effects markedly compromise cardiac function, increasing the likelihood of cardiac arrest. These mechanisms necessitate comprehensive management strategies in B-cell lymphoma patients. In this case report we present a case of cardiac arrest in a 59-year-old female woman with hypocalcemia and lactic acidosis secondary to B-cell lymphoma.

Learning points: Lactic acidosis in B-cell lymphoma can be multifactorial. Contributing factors include inability of liver lactate clearance, tumor cell metabolism or impaired oxygenation.Patients with B-cell lymphoma may have hypocalcemia secondary to tumor lysis syndrome, paraneoplastic syndrome, or secondary to treatment.These reversible causes should always be considered in cardiac arrest in cancer patients.

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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
166
审稿时长
8 weeks
期刊介绍: The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.
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