We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy

Tumor Lysis Syndrome Essay

Essay Topic:

Sorry, but copying text is forbidden on this website!

Tumor Lysis Syndrome by NinjaMom Tumor Lysis Syndrome is a series of metabolic derangements which may begin shortly after the onset of treatment of malignancies. It can lead to any of the following: · hyperphosphatemia· lactic acidosis (metabolic acidosis) · hypocalcemia· hyperuricemia · hyperkalemia· acute renal failure Tumor Lysis Syndrome (TLS): · is caused by the destruction of many rapidly proliferating neoplastic cells · is most commonly associated with a Burkitt’s lymphoma or acute lymphocytic leukemia · can occur after treatment of nearly any malignancy · occurs shortly (1-5 days) after onset of chemotherapy can occur spontaneously, but this is rare There are no definite parameters to diagnosing TLS, but there is a guideline as to how to measure disease severity.

We will write a custom essay on Tumor Lysis Syndrome specifically for you
for only $16.38 $13.90/page

Order now

This is the Cairo-Bishop method. Laboratory TLS – two or more of the following: · uric acid level ;gt; 8· potassium level ;gt; 6 · phosphorus level ;gt; 4. 5· calcium level ;lt; 7 Clinical TLS – any of the above laboratory values with an elevated serum creatinine, a new arrhythmia, seizure or sudden death Hyperphosphatemia · caused by the release of intracellular phosphate pools within tumor cells · causes a reciprocal decrease in serum calcium, which then causes the deposition of calcium phosphate crystals in the renal tubules and in the microvasculature, and can lead to acute renal failure · treat with oral phosphate binders Hypocalcemia · usually a reciprocal decrease caused by hyperphosphatemia · QT prolongation · positive Chvostek and Trousseau’s signs · bronchospasm, seizures, anxiety, tetany, encephalopathy, unexplained dementia or psychosis, parasthesias · often resolves without intervention as the phosphate levels return to normal · do NOT correct unless severe neurological symptoms present as this may predispose the patient to hypercalcemia as the phosphate levels normalize

Hyperkalemia · caused by intracellular potassium release from tumor lysis · worsed with a metabolic acidosis · shortened QT interval, peaked T waves, flattened P waves, prolonged PR interval, wide QRS, deep S wave, sine waves, ventricular arrhythmias, asystole, death · often the first life-threatening abnormality identified · treat with restriction of dietary potassium, kayexelate, and IV glucose and insulin · if K > 6. 5, calcium gluconate or calcium carbonate may be given for cardioprotecion Hyperuricemia · caused by the rapid turnover of nucleic acids uric acid can precipitate in the tubules, medulla, and collecting ducts of the kidney · elevated levels can lead to nausea/vomiting, arthralgias, and lethargy · worsened by a metabolic acidosis · treat with allopurinol · may treat with rasburicase · may magnify clinical hypocalcemia · if prior treatment ineffective, acetazolamide may be used Metabolic Acidosis · caused by release of endogenous intracellular acids · elevated anion gap · decreased serum bicarbonate levels · decreased uric acid solubility · increased calcium phosphate solubility Acute Renal Failure · oligoanuric · causes volume overload, pulmonary edema precipitated by uric acid crystallization, calcium phosphate crystallization · if conservative medical management does not correct these abnormalities, emergent dialysis is warranted to prevent permanent kidney damage The likelihood of developing TLS depends on several factors: · tumor burden· renal function · uric acid level·

LDH level · tumor sensitivity to treatment· elderly age Pre-treatment care: · CBC· LDH level · CMP· uric acid level · ionized calcium· hydration ·possible pre-alkalinization of the urine Post-treatment care: · close monitoring for 48-72 hours after treatment continuous cardiac monitoring · hydration · BUN’s TID · measurement of urine pH TID · dialysis if indicated References Berkow, Robert, M. D. et al, eds. “Tumor Lysis Syndrome. ” The Merck Manual of Diagnosis and Therapy. 13th ed. New Jersey: Merck ; Co. , Inc. 1977. Braunwald, Eugene, M. D. et al, eds. “Tumor Lysis Syndrome. ” Harrison’s Principles of Internal Medicine. 15th ed. New York: McGraw-Hill, 2001. Fernandez, Pedro, M. D. , Richard Larson, M. D. , and Zalman Agus, M. D. “Tumor Lysis Syndrome. ” www. uptodate. com 2007. Ikeda, Alan, M. D. et al. “Tumor Lysis Syndrome. ” www. emedicine. com. 2006.

How to cite this page

Choose cite format:

Tumor Lysis Syndrome. (2018, May 05). Retrieved from https://studymoose.com/tumor-lysis-syndrome-essay

We will write a custom sample essay onTumor Lysis Syndromespecifically for you

for only $16.38 $13.90/page
Order now

Our customer support team is available Monday-Friday 9am-5pm EST. If you contact us after hours, we'll get back to you in 24 hours or less.

By clicking "Send Message", you agree to our terms of service and privacy policy. We'll occasionally send you account related and promo emails.
No results found for “ image
Try Our service
online

Hi, I am Sara from Studymoose

Hi there, would you like to get such a paper? How about receiving a customized one? Click to learn more https://goo.gl/CYf83b

online

Hi, I am Sara from Studymoose

Hi there, would you like to get such a paper? How about receiving a customized one? Click to learn more https://goo.gl/CYf83b

image

Your Answer is very helpful for Us
Thank you a lot!