Aldabain Louay, Camire Lyn, Weisman David S
Department of Medicine, MedStar Health Internal Medicine Residency Program, Baltimore, MD, USA.
School of Medicine, Georgetown University, Washington, DC, USA.
J Community Hosp Intern Med Perspect. 2020 Aug 2;10(4):365-368. doi: 10.1080/20009666.2020.1781748.
Spontaneous tumor lysis syndrome is an uncommon oncologic emergency. It occurs when a massive number of malignant cells release their contents to the blood stream without previous cancer treatment. TLS carries a mortality rate exceeding 15%. Because of the high mortality rate, the key to the management of TLS continues to be early recognition of high-risk patients and using prophylactic measures to prevent its occurrence. However, it remains difficult to completely eradicate TLS, as a small proportion of patients with aggressive tumors develop spontaneous TLS prior to receiving any therapy. We present a case of 58-year-old male with recently diagnosed multiple myeloma. He was found to have hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia, elevated LDH levels, and acute renal failure, fulfilling the criteria of clinical TLS. He was treated with rasburicase, continuous renal replacement therapy, and dexamethasone.
自发性肿瘤溶解综合征是一种罕见的肿瘤急症。它发生于大量恶性细胞在未经先前癌症治疗的情况下将其内容物释放到血流中时。肿瘤溶解综合征的死亡率超过15%。由于死亡率高，肿瘤溶解综合征管理的关键仍然是早期识别高危患者并采取预防措施以防止其发生。然而，完全根除肿瘤溶解综合征仍然困难，因为一小部分侵袭性肿瘤患者在接受任何治疗之前就会发生自发性肿瘤溶解综合征。我们报告一例58岁男性，最近被诊断为多发性骨髓瘤。他被发现有高钾血症、高磷血症、高尿酸血症、低钙血症、乳酸脱氢酶水平升高以及急性肾衰竭，符合临床肿瘤溶解综合征的标准。他接受了重组尿酸氧化酶、连续性肾脏替代治疗和地塞米松治疗。
