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Spontaneous Tumor Lysis Syndrome in Diffuse Large B-cell Lymphoma: Early Diagnosis and Management.
Cureus 2019; 11(5):e4679C

Abstract

Spontaneous tumor lysis syndrome is a rare oncological emergency associated with multiorgan failure. It is characterized by an elevation of uric acid, hyperphosphatemia, hypocalcemia, hyperkalemia and renal failure in the setting of no active chemotherapy as a result of lysis of massive tumor burden. Early recognition of the disease and prompt management would affect morbidity and mortality. We present the case of an 80-year-old Caucasian male with a history of recently diagnosed diffuse large B-cell lymphoma who had worsening fatigue, weakness and decreased appetite for three days. On admission, laboratory investigations were significant for elevated creatinine, uric acid, and phosphorous. He was started on hemodialysis and rasburicase in view of hyperuricemia. Subsequently, chemotherapy was started. He tolerated chemotherapy initially but later developed multiorgan failure. His family then opted for comfort measures and the patient passed away soon after. In conclusion, spontaneous tumor lysis syndrome is a common association with hematological cancers. Prophylaxis with allopurinol and rasburicase is recommended in all patients who are at an increased risk for tumor lysis syndrome.

Authors+Show Affiliations

Internal Medicine, University of Pittsburgh Medical Center - UPMC - Pinnacle, Harrisburg, USA.Internal Medicine, University of Pittsburgh Medical Center - UPMC - Pinnacle, Harrisburg, USA.Internal Medicine, University of Pittsburgh Medical Center - UPMC - Pinnacle, Harrisburg, USA.Hematology-Oncology, Andrews and Patel Associates, Harrisburg, USA.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

31328070

Citation

Gangireddy, Mounika, et al. "Spontaneous Tumor Lysis Syndrome in Diffuse Large B-cell Lymphoma: Early Diagnosis and Management." Cureus, vol. 11, no. 5, 2019, pp. e4679.
Gangireddy M, Shrimanker I, Nookala VK, et al. Spontaneous Tumor Lysis Syndrome in Diffuse Large B-cell Lymphoma: Early Diagnosis and Management. Cureus. 2019;11(5):e4679.
Gangireddy, M., Shrimanker, I., Nookala, V. K., & Peroutka, K. A. (2019). Spontaneous Tumor Lysis Syndrome in Diffuse Large B-cell Lymphoma: Early Diagnosis and Management. Cureus, 11(5), pp. e4679. doi:10.7759/cureus.4679.
Gangireddy M, et al. Spontaneous Tumor Lysis Syndrome in Diffuse Large B-cell Lymphoma: Early Diagnosis and Management. Cureus. 2019 May 16;11(5):e4679. PubMed PMID: 31328070.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spontaneous Tumor Lysis Syndrome in Diffuse Large B-cell Lymphoma: Early Diagnosis and Management. AU - Gangireddy,Mounika, AU - Shrimanker,Isha, AU - Nookala,Vinod K, AU - Peroutka,Kathryn A, Y1 - 2019/05/16/ PY - 2019/7/23/entrez PY - 2019/7/23/pubmed PY - 2019/7/23/medline KW - allopurinol KW - hyperuricemia KW - rasburicase KW - renal failure KW - spontaneous tumor lysis syndrome SP - e4679 EP - e4679 JF - Cureus JO - Cureus VL - 11 IS - 5 N2 - Spontaneous tumor lysis syndrome is a rare oncological emergency associated with multiorgan failure. It is characterized by an elevation of uric acid, hyperphosphatemia, hypocalcemia, hyperkalemia and renal failure in the setting of no active chemotherapy as a result of lysis of massive tumor burden. Early recognition of the disease and prompt management would affect morbidity and mortality. We present the case of an 80-year-old Caucasian male with a history of recently diagnosed diffuse large B-cell lymphoma who had worsening fatigue, weakness and decreased appetite for three days. On admission, laboratory investigations were significant for elevated creatinine, uric acid, and phosphorous. He was started on hemodialysis and rasburicase in view of hyperuricemia. Subsequently, chemotherapy was started. He tolerated chemotherapy initially but later developed multiorgan failure. His family then opted for comfort measures and the patient passed away soon after. In conclusion, spontaneous tumor lysis syndrome is a common association with hematological cancers. Prophylaxis with allopurinol and rasburicase is recommended in all patients who are at an increased risk for tumor lysis syndrome. SN - 2168-8184 UR - https://www.unboundmedicine.com/medline/citation/31328070/Spontaneous_Tumor_Lysis_Syndrome_in_Diffuse_Large_B-cell_Lymphoma:_Early_Diagnosis_and_Management L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31328070/ DB - PRIME DP - Unbound Medicine ER -