{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:02:50Z","timestamp":1740164570149,"version":"3.37.3"},"reference-count":12,"publisher":"Wiley","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"name":"Abington Memorial Hospital."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Oncological Medicine"],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:p>A 70-year-old female with a history of mild cirrhosis was referred by her primary care provider for a platelet count of 36,000\/<jats:italic>\u03bc<\/jats:italic>L which had dropped from 47,000\/<jats:italic>\u03bc<\/jats:italic>L in a week along with mild pain in extremities. Serum potassium was low (2.9\u2009mEq\/L) in spite of the patient being recently started on potassium supplement on outpatient for hypokalemia. Initially thrombocytopenia was attributed to cirrhosis. However, platelet counts continued to drop to a nadir of 9000\/<jats:italic>\u03bc<\/jats:italic>L in spite of several platelet transfusions. Hypokalemia was refractory to potassium supplements. Subsequent bone marrow biopsy revealed extensive marrow necrosis with a focus of small cell tumor cells of pulmonary origin. CT scan of the chest showed a spiculated left lung mass. The ACTH level was high, with normal rennin and aldosterone levels. The patient likely had ectopic ACTH syndrome from small cell lung cancer. She died within few days of diagnosis. Severe thrombocytopenia and refractory hypokalemia can rarely be initial presentations of small cell lung cancer. Thrombocytopenia should prompt an evaluation for bone marrow metastases and a search for undiagnosed systemic malignancy. In severe cases of metastases, bone marrow necrosis can be present. Refractory hypokalemia can be the sole presentation of ectopic ACTH production.<\/jats:p>","DOI":"10.1155\/2014\/874831","type":"journal-article","created":{"date-parts":[[2014,5,15]],"date-time":"2014-05-15T17:12:49Z","timestamp":1400173969000},"page":"1-4","source":"Crossref","is-referenced-by-count":1,"title":["Small Cell Lung Cancer Presenting as Severe Thrombocytopenia and Refractory Hypokalemia"],"prefix":"10.1155","volume":"2014","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0749-9022","authenticated-orcid":true,"given":"Rohan","family":"Mandaliya","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Abington Memorial Hospital, Abington, PA 19001, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9347-3776","authenticated-orcid":true,"given":"Lesley","family":"Hughes","sequence":"additional","affiliation":[{"name":"Temple University School of Medicine, Philadelphia, PA 19140, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herbert","family":"Auerbach","sequence":"additional","affiliation":[{"name":"Department of Pathology, Abington Memorial Hospital, Abington, PA 19001, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felice","family":"LePar","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Abington Memorial Hospital, Abington, PA 19001, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1210\/edrv-15-6-752"},{"issue":"2","key":"2","first-page":"89","volume":"2","year":"2010","journal-title":"The European Journal of Clinical and Medical Oncology"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.10114"},{"first-page":"233","volume-title":"Small cell lung cancer","year":"2006","key":"4"},{"issue":"10","key":"5","doi-asserted-by":"crossref","first-page":"2442","DOI":"10.1002\/1097-0142(19950515)75:10<2442::AID-CNCR2820751009>3.0.CO;2-Q","volume":"75","year":"1995","journal-title":"Cancer"},{"issue":"1","key":"6","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1200\/JCO.1992.10.1.21","volume":"10","year":"1992","journal-title":"Journal of Clinical Oncology"},{"issue":"8664","key":"7","first-page":"640","volume":"2","year":"1989","journal-title":"The Lancet"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-1542"},{"issue":"1","key":"9","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1200\/JCO.1995.13.1.157","volume":"13","year":"1995","journal-title":"Journal of Clinical Oncology"},{"issue":"8","key":"10","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1002\/(SICI)1097-0142(20000415)88:8<1769::AID-CNCR3>3.0.CO;2-H","volume":"88","year":"2000","journal-title":"Cancer"},{"issue":"1","key":"11","first-page":"47","volume":"17","year":"1941","journal-title":"The American Journal of Pathology"},{"issue":"1","key":"12","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1002\/(SICI)1096-8652(199809)59:1<74::AID-AJH14>3.0.CO;2-1","volume":"59","year":"1998","journal-title":"The American Journal of Hematology"}],"container-title":["Case Reports in Oncological Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/crionm\/2014\/874831.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crionm\/2014\/874831.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crionm\/2014\/874831.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,6,22]],"date-time":"2017-06-22T09:17:21Z","timestamp":1498123041000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/crionm\/2014\/874831\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014]]},"references-count":12,"alternative-id":["874831","874831"],"URL":"https:\/\/doi.org\/10.1155\/2014\/874831","relation":{},"ISSN":["2090-6706","2090-6714"],"issn-type":[{"type":"print","value":"2090-6706"},{"type":"electronic","value":"2090-6714"}],"subject":[],"published":{"date-parts":[[2014]]}}}