Vaidya Gaurang Nandkishor, Acevedo Russell
Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY.
Department of Critical Care, Crouse Hospital, Syracuse, NY.
Am J Emerg Med. 2015 Feb;33(2):308.e1-2. doi: 10.1016/j.ajem.2014.07.039. Epub 2014 Aug 7.
Tumor lysis syndrome (TLS) is an oncologic emergency characterized by spillage of intracellular material into the blood caused by disruption of massive load of tumor cells. It is more commonly reported in hematological cancers and can have fatal consequences due to renal and multi-organ failure and arrhythmias due to electrolyte imbalance. We describe a case with metastatic breast cancer who presented with TLS after a single dose of paclitaxel, second such case in literature. The development of a risk stratification score to assess the need for hospitalization or close observation of these patients and the documentation of appropriate preventive strategies could help prevent such fatal occurrences. TLS should be included in the differential when cancer patients on treatment present with acute decompensation.
肿瘤溶解综合征(TLS)是一种肿瘤急症,其特征是大量肿瘤细胞被破坏,导致细胞内物质泄漏到血液中。它在血液系统癌症中更常见,由于肾衰竭、多器官功能衰竭以及电解质失衡导致的心律失常,可能会产生致命后果。我们描述了一例转移性乳腺癌患者,在单次使用紫杉醇后出现了TLS,这是文献中报道的第二例此类病例。制定风险分层评分以评估这些患者是否需要住院或密切观察,并记录适当的预防策略,有助于预防此类致命事件的发生。当接受治疗的癌症患者出现急性失代偿时,应将TLS纳入鉴别诊断。