Albumin-bound paclitaxel as new treatment for metastatic cholangiocarcinoma: A case report

Table 1 Diarrhea lab work

Diarrhea lab work
Hormonal and enzymatic study	Normal range
Thyrotropin, TSH	0.888 µIU/mL
Free T4	1.10 ng/dL
Free T3	2.57 pg/mL
Serum cortisol	16.50 µg/dL
ACTH	34.38 pg/mL
Pancreatic elastase E1	More than 437 µg/g of dry stool
Microbiology study	No pathogenic microorganisms identified
Stool culture	Usual bacterial flora in the sample
Clostridium difficile toxin/glutamate dehydrogenase	Negative
Autoimmunity study	Negative for celiac disease
Anti-transglutaminase immunoglobulin-A antibodies	3.63 UA/mL

We carried out a detailed study of diarrhea to rule out non-cancer-related causes. We confirmed that diarrhea was a symptom of the patient’s cancer (peritoneal carcinomatosis). ACTH: Adrenocorticotropic hormone; TSH: Thyroid-stimulating hormone.

Table 2 Pleural effusion study

Pleural effusion study
Pleural effusion biochemistry
Glucose	92 mg/dL
Total proteins	4.1 g/dL
Albumin	2.7 g/dL
Lactate dehydrogenase	137 IU/L
Cholesterol	12 mg/dL
Triglycerides	182 mg/dL
Adenosine deaminase	Not available
Pleural effusion hemogram
Hemoglobin	0.2 g/dL
Platelets	2600/µL
White blood cells	850/µL
Neutrophils	0
Lymphocytes	800/µL
Blood test biochemistry
Glucose	86 mg/dL
Total proteins	6 g/dL
Albumin	3.5 g/dL
Lactate dehydrogenase	208 IU/L
Cholesterol	195 mg/dL
Triglycerides	122 mg/dL
Microbiology study	No pathogenic microorganisms identified
Light’s criteria	The pleural effusion meets two of three of Light’s criteria for exudate, and is compatible with cancer
Ratio pleural/serum proteins	0.68 (> 0.5)
Ratio pleural/serum proteins	0.65 (> 0.6)
Pleural effusion lactate dehydrogenase > 2/3 upper limit of normal	No

We conducted an extensive study of pleural fluid to rule out non-cancer-related causes. The presence of cancer cells in the pleural effusion was confirmed by cytology.