Tumor lysis syndrome resident survival guide: Difference between revisions

Revision as of 20:52, 18 January 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Twinkle Singh, M.B.B.S. [2]

Definition

Tumor lysis syndrome (TLS) is a group of metabolic abnormalities resulting from rapid lysis of malignant cells and massive release of cell breakdown products into blood. It is a life threatening condition and an oncologic emergency. Metabolic complications include hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia and hyperuricosuria.

Causes

Life Threatening Causes

Tumor lysis syndrome resulting from any cause is a life threatening condition and needs immediate management.

Common Causes

Commonly tumor lysis syndrome is precipitated by chemotherapy in patients with hematologic malignancies.

Classification

Cairo and Bishop classified and graded TLS as laboratory tumor lysis syndrome (LTLS) and clinical tumor lysis syndrome (CTLS). Laboratory tumor lysis syndrome

Element	Value	Change from baseline
Uric acid	≥476 μmol/L or 8 mg/dL	25 % increase
Potassium	≥6 mmol/L or 6mg/L	25 % increase
Phosphorus	≥2.1 mmol/L for children ≥1.45 mmol/L for adults	25 % increase
Calcium	≤1.75 mmol/L	25% decrease

Management

Shown below is an algorithm summarizing the approach to [[disease name]].

References

Template:WikiDoc Sources

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 ===Life Threatening Causes===
 Tumor lysis syndrome resulting from any cause is a life threatening condition and needs immediate management.
 ===Common Causes===
@@ Line 19: / Line 20: @@
 * [[Non-Hodgkin's lymphoma]]
 * [[Multiple myeloma]]
+===Classification===
+Cairo and Bishop classified and graded TLS as laboratory tumor lysis syndrome (LTLS) and clinical tumor lysis syndrome (CTLS).
+Laboratory tumor lysis syndrome
+{|border="1" cellpadding="5" cellspacing="0"
+|-
+|style="border-bottom:3px solid grey;" align="center" width="200" style="background:#efefef;"|'''Element''' ||style="border-bottom:3px solid grey;" align="center" width="200" style="background:#efefef;"|'''Value''' ||style="border-bottom:3px solid grey;" align="center" width="200" style="background:#efefef;"|'''Change from baseline'''
+|-
+|Uric acid ||≥476 μmol/L or 8 mg/dL ||25 % increase
+|-
+|Potassium ||≥6 mmol/L or 6mg/L || 25 % increase
+|-
+|Phosphorus ||≥2.1 mmol/L for children<br>≥1.45 mmol/L for adults ||25 % increase
+|-
+|Calcium ||≤1.75 mmol/L || 25% decrease
+|-
+|}
 ==Management==
 Shown below is an algorithm summarizing the approach to <nowiki>[[disease name]]</nowiki>.