临床病例讨论 高血糖、低血钾伴胰腺肿瘤

Hyperglycemia and hypokalemia with a pancreatic tumor

中年男性患者 ,以高血糖、严重低血钾入院。伴消瘦、皮肤薄、脸圆 ,精神症状。CT示胰腺肿瘤 ;垂体无异常。结合血尿皮质醇、血ACTH、地塞米松抑制试验结果拟诊为异位ACTH综合征。本文就此病的诊断、鉴别及治疗进行了讨论。

A mid-aged male patient manifested hyperglycemia, severe hypokalemia, weight loss, thin skin, round face and psychoneurotic symptoms without hypertension. CT showed a pancreatic tumor and a normal pituitary image. Preliminary assessment (blood and urinary cortisol, blood ACTH and dexamethasone suppression test) supported the diagnosis of ectopic ACTH syndrome. The differential diagnosis and treatment of this disease were discussed.