Q: Tumor lysis syndrome (TLS) is an oncologic emergency. All of the following electrolyte derangements can occur in TLS except?
A) Hyperphosphatemia
B) Hypercalcemia
C) Hyperkalemia
D) Hyperuricemia
E) Xanthinuria
Answer: B
Hyperphosphatemia and consequently hypocalcemia are one of the hallmark of TLS. The phosphorus concentration in malignant cells are much higher than in normal cells. Its combination with calcium (calcium-phosphate) causes marked hypocalcemia. Actually it is calcium-phosphate precipitation in the renal tubules which leads to AKI (acute kidney injury) in TLS. If calcium phosphate product goes to more than or equal to 70 mg2/dL2, CRRT should be strongly considered.
With breakdown of cells, life threatening hyperkalemia and hyperuricemia may occur. Most patients with TLS receives allopurinol which causes xanthine precipitation in the tubules.
A) Hyperphosphatemia
B) Hypercalcemia
C) Hyperkalemia
D) Hyperuricemia
E) Xanthinuria
Answer: B
Hyperphosphatemia and consequently hypocalcemia are one of the hallmark of TLS. The phosphorus concentration in malignant cells are much higher than in normal cells. Its combination with calcium (calcium-phosphate) causes marked hypocalcemia. Actually it is calcium-phosphate precipitation in the renal tubules which leads to AKI (acute kidney injury) in TLS. If calcium phosphate product goes to more than or equal to 70 mg2/dL2, CRRT should be strongly considered.
With breakdown of cells, life threatening hyperkalemia and hyperuricemia may occur. Most patients with TLS receives allopurinol which causes xanthine precipitation in the tubules.
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