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Sixty-eight-year-old patient with hypokalemia
G Innemee1, P H De Meijer, A E Meinders
1Department of General Internal Medicine, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
The Netherlands Journal of Medicine
|March 14, 2001
Summary
A patient with severe hypokalemia and metabolic alkalosis was diagnosed with metastatic small cell lung cancer. The cancer caused a high concentration of adrenocorticotropic hormone, leading to these electrolyte imbalances.
Area of Science:
- Endocrinology
- Oncology
Background:
- Severe hypokalemia and metabolic alkalosis can present diagnostic challenges.
- Small cell bronchial carcinoma is a known malignancy with potential paraneoplastic syndromes.
Observation:
- A 68-year-old male presented with severe hypokalemia and metabolic alkalosis.
- The patient had a history of small cell bronchial carcinoma treated six years prior.
Findings:
- Diagnostic workup revealed metastatic small cell carcinoma.
- Elevated plasma adrenocorticotropic hormone (ACTH) concentration was identified.
- Malignancy-induced corticotropin-releasing hormone (CRH) production was suspected as the cause of hyperACTH-emia.
Implications:
- This case highlights the importance of considering paraneoplastic syndromes in patients with electrolyte disturbances and a history of cancer.
- Metastatic small cell lung cancer can manifest with ectopic hormone production, leading to severe metabolic derangements.
- Understanding the link between malignancy and hormonal imbalances is crucial for accurate diagnosis and management.