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从有毒摄入到癌症:剧烈的酸性化作为骨髓瘤定义事件
Nicholas J Burkholder1, Lauren M Sweet1, Erin L Kelly2
1Internal Medicine, Brooke Army Medical Center, San Antonio, USA.
Cureus
|June 5, 2023
概括
这一案例凸显了急性功能衰竭如何可能源于多发性骨髓瘤等意想不到的原因,而不仅仅是毒性酒精摄入. 骨髓瘤的早期诊断对于保持功能至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
- 内部医学 内部医学
背景情况:
- 急性功能衰竭 (AKF) 呈现出各种不同的病因.
- 阳离子间隙和度间隙的升高可以表明有毒酒精摄入.
- 多发性髓瘤是一种具有潜在脏表现的血液性恶性瘤.
研究的目的:
- 介绍一个AKF病例和改变的思维,最初怀疑是有毒酒精摄入.
- 为了说明多发性骨髓瘤如何表现出模仿其他疾病的代谢障碍.
- 强调考虑AKF更广泛的差异诊断的重要性.
主要方法:
- 一个病人的病例报告,有过滥用酒精和自杀企图的病史.
- 临床表现包括AKF,变化的思维,离子间隙代谢酸性化和升高的度间隙.
- 诊断工作导致了多发性骨髓瘤的鉴定.
主要成果:
- 患者的表现模仿了由于代谢酸化和胞间隙而导致的有毒酒精中毒.
- 确定的诊断是多发性骨髓瘤,在这种情况下,这是AKF的罕见原因.
- 这一案例强调了解释代谢差距的复杂性.
结论:
- 阴离子和奥斯莫拉间隙可能会受到除了毒性摄入之外的其他条件的影响.
- 多发性骨髓瘤可以显著呈现AKF和改变精神状态.
- 及时识别和化疗对于在急性骨髓瘤中维护功能至关重要.
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