D) Hyperuricemia
Tumor lysis syndrome is an oncologic emergency, most commonly seen after initiating chemotherapy, particularly in a patient with newly diagnosed leukemia and a very high WBC count and in high grade / advanced lymphomas. A rapid turnover of tumor cells leads to a massive release of intracellular ions. Findings include: hyperkalemia, hyperphosphatemia, hypocalcemia (due to chelation of phosphorus), hyperuricemia and elevated LDH (due to rapid cell turnover). Treatment for tumor lysis syndrome includes rapid volume expansion, allopurinol or febuxostat (decrease uric acid production), recombinant urate oxidase (rasburicase), urine alkalinization with NaHCO3 to enhance uric acid if rasburicase not immediately available, calcium, hyperkalemia treatment as indicated.
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November 30, 2023 at 9:16 pm
D) Hyperuricemia
Tumor lysis syndrome is an oncologic emergency, most commonly seen after initiating chemotherapy, particularly in a patient with newly diagnosed leukemia and a very high WBC count and in high grade / advanced lymphomas. A rapid turnover of tumor cells leads to a massive release of intracellular ions. Findings include: hyperkalemia, hyperphosphatemia, hypocalcemia (due to chelation of phosphorus), hyperuricemia and elevated LDH (due to rapid cell turnover). Treatment for tumor lysis syndrome includes rapid volume expansion, allopurinol or febuxostat (decrease uric acid production), recombinant urate oxidase (rasburicase), urine alkalinization with NaHCO3 to enhance uric acid if rasburicase not immediately available, calcium, hyperkalemia treatment as indicated.