Haematological emergencies - tumour lysis syndrome
Description
- Massive release of intracellular contents from dying tumour cells outpacing renal clearance
- The tetrad: inc K+, inc phosphate, inc urate, dec Ca2+ (secondary, from calcium-phosphate precipitation)
- -> AKI, arrhythmia, seizures, death
- Usually 12-72 h after starting cytotoxic therapy, but can be spontaneous in very high-turnover disease
- Spontaneous TLS: urate high, phosphate often normal - the cells reuse released phosphate for continued proliferation
- Preventable. The only reliably effective management is anticipating it.
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