Agnani S, Gupta R, Atray N K, Vachharajani T J
Departments of Internal Medicine and Nephrology, Louisiana State University Health Sciences Center, Shreveport, LA 71101, USA.
Int J Clin Pract. 2006 Mar;60(3):364-6. doi: 10.1111/j.1742-1241.2005.00623.x.
Spontaneous tumour lysis syndrome (TLS) is an extremely uncommon cause for acute renal failure (ARF). ARF presenting with hyperkalemia, hyperuricemia and hyperphosphatemia should lead to further work up for occult haematological malignancy. We describe two cases of lymphoma presenting with ARF secondary to spontaneous TLS. The ARF in the first case appeared to be due to intravenous volume depletion but eventually lead to the diagnosis of gastric lymphoma. The second patient is interesting as he is probably the first reported case of lymphoma with HIV infection presenting as spontaneous TLS. Early diagnosis and prompt renal replacement therapy does not necessarily reverse the ARF.
自发性肿瘤溶解综合征（TLS）是急性肾衰竭（ARF）极为罕见的病因。出现高钾血症、高尿酸血症和高磷血症的ARF应进一步检查以排查隐匿性血液系统恶性肿瘤。我们描述了两例因自发性TLS继发ARF的淋巴瘤病例。第一例患者的ARF似乎是由于静脉容量耗竭，但最终确诊为胃淋巴瘤。第二例患者很有意思，因为他可能是首例报道的因HIV感染并发淋巴瘤而表现为自发性TLS的病例。早期诊断和及时的肾脏替代治疗不一定能逆转ARF。
