SYNDROMES PARANEOPLASTIC

SYNDROMES PARANEOPLASTIC
"Paraneoplastic syndrome", the term emerged with the tumor, tumor and metastasis away from their places in the definitions of different symptoms. Paraneoplastic syndromes may be difficult to associate with tumor or metastasis.
FREQUENCY

Recognition of distress and symptoms masked by the underlying disease is difficult to assess the frequency of paraneoplastic syndromes. Assumed to develop 20 to 50 percent of patients with cancer of paraneoplastic syndrome. Loss of appetite, weight loss, electrolyte disturbances, fever, disproteinemi (blood protein imbalance) and cachexia (extreme weakness), as well as a number of general symptoms, paraneoplastic syndromes are known to specific organs and systems. These may be explained as follows:
• Normal or produced in different hormoriiann metabolic disorders or endocrine (internal secretion) those with disorders (33 percent);
• changes in skin and connective tissue (33 percent); • nerve and muscle disorders (16 percent);
• Blood and blood clotting, heart, vascular disorders (15 percent);
• organ and system disorders (gastro-intestinal, immünopoetik (immune builder) üropoetik (urine forming) disorders, 15 percent).
All tumors could be responsible for the emergence of paraneoplastic syndrome. But the lungs, the blood-lymph (leukemias, lymphomas, miyelomlar), breast, thyroid, thymus, and urogenital cancers (bladder, prostate, testis, kidney, uterus, ovary), and gastrointestinal tract (stomach, large intestine, liver, pancreas) cancers, paraneoplastic causes more frequent syndromes.
CLASSIFICATION
The diversity and complexity of mechanisms of clinical syndromes, paraneoplastic syndromes, makes it difficult to classify precisely. The symptoms of paraneoplastic syndromes of the following signs of cancer in general are discussed:
• Fever - Fever is one of the symptoms associated with tumors. Detecting the cause of fever in patients namadığı research, 10 percent of these cases of extrapulmonary tuberculosis, Hodgkin's disease, and kidney tumors in 10 percent (hipernef-rom), in 4 per cent of that also revealed other types of carcinoma. How fire affects the course of the tumors is not well known among patients with tumors and tumor-mörsüz no significant differences for the course of the disease. As is known, the fire, some of the substances produced by white blood cells in the circulatory system (pi-rojenler) to affect the hypothalamus of the brain at the level of the result. Although not definitive, paraneoplastic syndromes, fever, cellular and humoral immune mechanisms and processes of the complex may be due to the destruction of tumor antigens. Lymphoma and leukemia (blood cancer) are often located in the fire. Leukemias fever, the disease is caused by advanced stages of the infection.
Lenfomlarda and Hodgkin's disease, especially fever, can be a symptom that accompanies tumor and is usually the course of a disease-specific (fluctuating fever).
• increased sedimentation rate - a high sedimentation rate, the tumor can not be explained in the elderly, especially hipemefrom (kidney tumor) are suggestive of the possibility. 'Fazlasmda one-third of patients with renal tumors detected by high sedimentation rate.
• Anemia - Anemia (anemia), an important condition associated with tumors. Was seen quite often, these diseases are generally regarded as one of the signs.
• metabolic - endocrine syndromes or hormone-like hormone-producing tumors caused by substances endocrine function (endocrine function)-related clinical conditions. The most common ones are described below:
- Change-s at the level of blood calcium. Changes in calcium metabolism, blood tumors, bone tumors and produced by impact of the substances (parathyroid hormone-like substances, calcitonin) describes the effect.
a) Hypercalcemia - is common in patients with bone metastases are common. The most common metabolic-endocrine syndrome tumors (malignant tumors seen in 10 percent). Although it resembles hyperparathyroidism, high parathyroid hormone in circulation rate is rare. In some cases, the pa-rathormona found a substance similar to the parathyroid hormone concentration is usually lower than in patients with primary hyperparathyroidism. Impossible to make definitive comments. Changes in vitamin D metabolism, may be effective for other reasons, such as prostaglandin-s. Syndrome, the symptoms of hypercalcemia are very different. The blood calcium level was 10.5 mg per cent or higher when there is hypercalcemia.
The clinical picture of hypercalcemia, nausea, vomiting, abdominal pain with gastro-intestinal system disorders. Rapid increase in nitrogen, which causes water loss and excessive urination (polyuria) are seen. Discomfort with the more severe forms, such as seizures and coma, neurological disorders and cardiac disorders are usually seen in the resulting changes of electrocardiography.
Serum calcium levels, and electrocardiographic changes to reveal symptoms of the syndrome will help you to meet. Osteolytic (leading to osteoporosis regional) events, as an absolute or relative intake of calcium and vitamin D increase, the increase intestinal absorption of calcium excretion in the kidneys or differential diagnosis in such cases should be reduced. In the case of paraneoplastic syndromes, symptoms, tumor (lung, kidney, ovarian, multiple myeloma) is due to be taken into consideration; hypercalcemia, caused by the presence of the tumor.
Always require emergency treatment of hypercalcemia. The body's self-regulatory mechanisms (increase in calcitonin and calcium absorption in bones), with the help of an appropriate amount of fluid intake of at least 50 percent of cases of hypercalcemia keeps under control. From the primary tumor therapy may provide control of the syndrome of hypercalcemia. Following the treatment of hypercalcemia of tumor gene may be magnified. Treatment in emergency situations adequate fluid intake, increase in urinary calcium excretion and calcium intake should be for the remainder.
b) Hypocalcemia - prostate, breast and lung tumors and lung tumors of the thyroid or connected metastazlanyla associated with excessive production of calcitonin are rare. Generally, calcitonin, hypocalcemia (low blood calcium levels are the low cost) does not cause any effect, because this hormone, the effect of prostaglandins produced by the tumor stabilizes.
Syndrome-specific symptoms, fatigue, restlessness and muscle contractions due to hypocalcemia. The diagnosis is based on the detection of hypocalcemia, the symptoms of low blood calcium levels. Hypocalcemia with high blood levels of calcitonin, medullary carcinoma of the thyroid on the demonstration as radyoimmünolojik (caused by thyroid cancer cells), bronchial carcinoma, and made a differential diagnosis of breast cancer bone metastases. Furthermore, the differential diagnosis is made with hypoparathyroidism. Calcium gluconate should be given through a vein in the treatment of hypocalcemia in acute stage and subsequently added to the treatment of vitamin D by mouth.