Tumor lysis syndrome differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]
Overview
Tumor lysis syndrome must be differentiated from other diseases that cause hyperuricemia, hyperkalemia, and hyperphosphatemia, such as acute kidney injury. The common conditions are hereditary hyperuricemia, Insulin resistance, Hypertension, Obesity, Gout, Alcoholism and renal insufficiency. Patients taking ACE inhibitor, NSAIDs and Antibiotics such as trimethoprim are more prone to hyperkalemia. Hyperphosphatemia is usually seen in Acute kidney injury, Hypoparathyroidism, vitamin D supplementation and also in sarcoidos.
Differentiating tumor lysis syndrome from other Diseases
Tumor lysis syndrome must be differentiated from other diseases that cause electrolytes disturbance.[1]
- Hereditary hyperuricemia
- Insulin resistance
- Hypertension
- Obesity
- Gout
- Alcoholism
- Renal insufficiency
- Medications:
- Renal insufficiency
- Medications
- ACE inhibitor
- angiotensin receptor blockers
- Potassium-sparing diuretics such asamiloride and spironolactone
- NSAIDs such as ibuprofen and naproxen
- Ciclosporin
- Tacrolimus
- Antibiotics such as trimethoprim
- Antiparasitic drugs such as pentamidine
- Mineralocorticoid deficiency or resistance:
- Addison's disease
- Aldosterone deficiency
- Some forms of congenital adrenal hyperplasia
- Type IV renal tubular acidosis
- Gordon's syndrome (pseudohypoaldosteronism type II)
- Acute kidney injury
- Hypoparathyroidism
- Vitamin D
- vitamin A intoxication
- Sarcoidosis
- Immobilization
- Osteolytic metastases
- Milk-alkali syndrome
- Severe hypermagnesemia or hypomagnesemia
- Pseudohypoparathyroidism
- Acromegaly
- Extensive cellular injury or necrosis:
- Crush injury
- Rhabdomyolysis
- Hyperthermia
- Fulminant hepatitis
- Severe hemolytic anemia
- Transcellular phosphate shifts:
References
- ↑ Wilson FP, Berns JS (2014). "Tumor lysis syndrome: new challenges and recent advances". Adv Chronic Kidney Dis. 21 (1): 18–26. doi:10.1053/j.ackd.2013.07.001. PMC 4017246. PMID 24359983.
- ↑ 2.0 2.1 2.2 Wikipedia.https://en.wikipedia.org/wiki/Hyperuricemia