Arch Argent Pediatr. 2020 Apr;118(2):S59-S63. doi: 10.5546/aap.2020.S59.
The tumor lysis syndrome represents a potentially lethal complication caused by the massive release of nucleic acids, potassium and phosphate into the circulation as a result of the lysis of neoplastic cells, which are characterized by a rapid proliferation capacity and high sensitivity to drugs. This may occur spontaneously prior to the start of treatment, becoming worse after the initiation of chemotherapy. It presents a high mortality; its prevention continues being the most important therapeutic measure. The clinical picture is characterized by the existence of hydroelectrolytic metabolism disorders, in particular hyperkalemia, hyperphosphatemia and hyperuricemia and by the appearance of an acute renal lesion. Adequate therapeutic intervention involves intravenous hydration and measures to prevent or correct metabolic alterations. This article proposes guidelines to follow both in the diagnostic stage and in the treatment of this complication.
肿瘤溶解综合征是一种潜在的致命并发症,由肿瘤细胞溶解导致核酸、钾和磷酸盐大量释放进入循环系统引起,这些肿瘤细胞具有快速增殖能力且对药物高度敏感。这种情况可能在治疗开始前自发出现,化疗开始后会加重。它具有高死亡率;预防仍然是最重要的治疗措施。临床表现的特征是存在水电解质代谢紊乱,特别是高钾血症、高磷血症和高尿酸血症,以及出现急性肾损伤。充分的治疗干预包括静脉补液以及预防或纠正代谢改变的措施。本文提出了在该并发症的诊断阶段和治疗中应遵循的指导原则。