Lessons from an unusual case: malignancy associated hypercalcemia, pancreatitis and respiratory failure due to ARDS.
A 37-year old woman, presenting with severe hypercalcaemia-associated pancreatitis with pseudocyst formation, was admitted to intensive care because she developed ARDS with respiratory failure. Skeletal metastasis from non-small cell bronchial carcinoma were subsequently diagnosed. After she developed arterial occlusion in the lower limb, supportive treatment was withdrawn. Severe pancreatitis is an exceedingly unusual presentation of non-small cell bronchial carcinoma. Concepts of diagnostic and therapeutic strategies in the context of suspected unusual pathology, and the concept of futility are briefly discussed.
Department of Internal Medicine, Groningen University, The Netherlands.
A N
AN
Wymenga
T S
TS
van der Werf
W T
WT
van der Graaf
J E
JE
Tulleken
J G
JG
Zijlstra
J J
JJ
Ligtenberg
D000328:Adult; D001859:Bone Neoplasms / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D007866:Leg; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D010195:Pancreatitis / Q000209:etiology*; D011644:Puerperal Disorders / Q000175:diagnosis*; D012128:Respiratory Distress Syndrome / Q000209:etiology*; D013924:Thrombophlebitis / Q000209:etiology