Department of Emergency Medicine, Jesse Brown Veterans Affairs Medical Center, 820 S Damen Avenue, Chicago, IL 60612, United States of America.
Department of Emergency Medicine, Jesse Brown Veterans Affairs Medical Center, 820 S Damen Avenue, Chicago, IL 60612, United States of America; Department of Medicine, Northwestern Medicine Feinberg School of Medicine, 420 E Superior Street, Chicago, IL 60611, United States of America.
Am J Emerg Med. 2023 May;67:195.e5-195.e6. doi: 10.1016/j.ajem.2023.03.023. Epub 2023 Mar 17.
Tumor Lysis Syndrome (TLS) is a metabolic emergency seen in patients who receive cytotoxic chemotherapy and can result in significant morbidity and mortality, especially in those patients with high tumor burden. Spontaneous tumor lysis syndrome (STLS) occurs in patients without preceding chemotherapy but may occur in the setting of glucocorticoid administration. We present a case of a 75-year-old male with a history of myelodysplastic syndrome who presented with shortness of breath and developed acute renal failure due to tumor lysis syndrome, likely triggered by candidemia. To our knowledge, this is the first known case of STLS in a patient with high tumor burden who did not receive corticosteroids but likely developed this condition in the setting of infection.
肿瘤溶解综合征(TLS)是接受细胞毒性化疗的患者中出现的一种代谢急症,可导致严重的发病率和死亡率,尤其是在那些肿瘤负担高的患者中。自发性肿瘤溶解综合征(STLS)发生在没有先前化疗的患者中,但可能在糖皮质激素给药的情况下发生。我们报告了一例 75 岁男性的病例,该患者患有骨髓增生异常综合征,因肿瘤溶解综合征出现呼吸急促,并因念珠菌血症导致急性肾衰竭。据我们所知,这是首例已知的高肿瘤负担患者在未接受皮质类固醇治疗但可能在感染情况下发生这种情况的 STLS 病例。