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[Nephro-Urology] Clinical Practice Note

Paraneoplastic syndrome
由腫瘤細胞分泌的hormone造成的一些臨床症狀,第一線的醫師必須要注意這些變化切記四大症狀:紅血球增加、高血鈣、高血壓、非轉移肝功能失調。

a. Erythrocytosis:因為局部的缺氧造成erythropoietin分泌,造成紅血球的增加。
b. Hypercalcemia:類似副甲狀腺(PTH)機能亢進,所以會產生高血鈣。
c. Hypertension:由於renin增加導致高血壓。
d. Nonmetastatic hepatic dysfunction (Stauffer’s syndrome)必考:病人的肝臟是好的,沒有B或C肝,但肝臟的功能卻很差,可能會有肝功能異常、發燒、疲勞、體重減輕等肝病的症狀,然而在把RCC去除以後,這些狀況就會改善了。(此為以後到泌尿外科時張聖原張院長最喜歡問的題目,臨床上也會見到,這是此堂課最重要的重點,國考也會考,請同學一定要牢記在心!)

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