Duzova A, Cetin M, Gümrük F, Yetgin S
Department of Pediatrics, Pediatric Nephrology and Rheumatology Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Eur J Haematol. 2001 Jun;66(6):404-7. doi: 10.1034/j.1600-0609.2001.066006404.x.
Acute tumour lysis syndrome (ATLS) is a well recognised complication of treatment of a variety of malignant disorders. It commonly occurs in patients with non-Hodgkin's lymphoma (NHL) and acute lymphoblastic leukaemia (ALL) with the administration of combined cytotoxic chemotherapy. It is rarely reported after single-agent corticosteroid therapy. We present two children with acute lymphoblastic leukaemia of T-cell lineage who developed acute tumour lysis syndrome after a single dose of prednisolone, and methylprednisolone at the beginning of the induction chemotherapy. In the first case (an 11-yr-old) ATLS had occurred after an oral dose of prednisolone as small as 12 mg and within 18 h. The second case was a 14-yr-old boy with ALL who developed ATLS following a single dose of methylprednisolone. A few similar cases in the English literature are summarised in the report. These cases indicate that acute tumour lysis syndrome may occur after a single dose of corticosteroids. One should be aware of this potentially life-threatening complication especially while prescribing corticosteroids to patients with NHL and leukaemia.
急性肿瘤溶解综合征（ATLS）是各种恶性疾病治疗中一种广为人知的并发症。它常见于接受联合细胞毒性化疗的非霍奇金淋巴瘤（NHL）和急性淋巴细胞白血病（ALL）患者。单药皮质类固醇治疗后很少有相关报道。我们报告了两名T细胞系急性淋巴细胞白血病患儿，在诱导化疗开始时单次给予泼尼松龙和甲泼尼龙后发生了急性肿瘤溶解综合征。第一例（一名11岁儿童）口服仅12 mg泼尼松龙后18小时内就发生了ATLS。第二例是一名14岁患ALL的男孩，单次给予甲泼尼龙后发生了ATLS。报告中总结了英文文献中的一些类似病例。这些病例表明，单次给予皮质类固醇后可能发生急性肿瘤溶解综合征。尤其是在给NHL和白血病患者开皮质类固醇药物时，应意识到这种可能危及生命的并发症。
