Saravu Kavitha, Kumar Suresh, Shastry Ananthakrishna Barkur, Kurien Annamma, Prabhu Ravindra, Kumar Rishikesh
Department of Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
Australas Med J. 2013 Mar 31;6(3):168-71. doi: 10.4066/AMJ.2013.1592. Print 2013.
We describe a case of a 40-year-old male patient who was found to have multiple myeloma with spontaneous tumour lysis syndrome (TLS), following a compression fracture of the L-2 vertebrae. Multiple myeloma was confirmed by bone marrow analysis and the M-band on serum protein electrophoresis. Hyperuricaemia (26.2 mg/dL), hyperkalaemia (> 7.0 mEq/L), hyperphosphatemia (16.2 mg of phosphorus/dL), normocalcemia and acute kidney injury, prior to anticancer treatment suggested spontaneous TLS. Inciting events for tumour lysis, such as chemotherapy, dehydration and exposure to steroids were absent. Patient received hydration, hypourecemic drugs and haemodialysis. This case report highlights the rare presentation of multiple myeloma with spontaneous TLS.
我们描述了一例40岁男性患者，该患者在L2椎体压缩性骨折后被发现患有多发性骨髓瘤并伴有自发性肿瘤溶解综合征（TLS）。骨髓分析和血清蛋白电泳上的M带证实了多发性骨髓瘤。在抗癌治疗前，高尿酸血症（26.2mg/dL）、高钾血症（>7.0mEq/L）、高磷血症（16.2mg磷/dL）、血钙正常和急性肾损伤提示自发性TLS。不存在诸如化疗、脱水和接触类固醇等肿瘤溶解的诱发因素。患者接受了补液、降尿酸药物和血液透析治疗。本病例报告强调了多发性骨髓瘤伴自发性TLS的罕见表现。
