PDF(Pubmed)
Abstract：
BACKGROUND: Tumor lysis syndrome (TLS) is a hematologic oncological emergency characterized by metabolic and electrolyte imbalances. On breakdown of tumor cells, enormous amounts of potassium, phosphate, and nucleic acids are released into systemic circulation. TLS mainly occurs during chemotherapy. However, there are rare incidences of spontaneous tumor lysis syndrome (STLS) prior to commencement of therapy.
METHODS: In the case being reported, the child had just undergone a biopsy. As the incision was being closed, there was a sudden onset of high fever, arrhythmia, severe hyperkalemia, hypocalcemia, and acidosis. Following timely symptomatic treatment and continuous renal replacement therapy(CRRT), the child\'s laboratory results improved, and organ function was restored to normal. The final pathological diagnosis confirmed Burkitt lymphoma. The boy is currently on maintenance chemotherapy.
CONCLUSIONS: TLS is a potentially life-threatening complication in hematologic oncology. Several important conclusions can be drawn from this case, reminding clinicians to: (1) be fully aware of the risk factors of TLS and evaluate the level of risk; (2) pay attention to the possibility of STLS during operation, if surgical procedures are necessary and operate with minimal trauma and in the shortest time possibly; (3) take preoperative prophylaxis actively for high-risk TLS patients, including aggressive fluid management and rational use of diuretics and uric-acid-lowering drugs. In addition, this case confirms the effectiveness of CRRT for severe STLS.
METHODS: In the case being reported, the child had just undergone a biopsy. As the incision was being closed, there was a sudden onset of high fever, arrhythmia, severe hyperkalemia, hypocalcemia, and acidosis. Following timely symptomatic treatment and continuous renal replacement therapy(CRRT), the child\'s laboratory results improved, and organ function was restored to normal. The final pathological diagnosis confirmed Burkitt lymphoma. The boy is currently on maintenance chemotherapy.
CONCLUSIONS: TLS is a potentially life-threatening complication in hematologic oncology. Several important conclusions can be drawn from this case, reminding clinicians to: (1) be fully aware of the risk factors of TLS and evaluate the level of risk; (2) pay attention to the possibility of STLS during operation, if surgical procedures are necessary and operate with minimal trauma and in the shortest time possibly; (3) take preoperative prophylaxis actively for high-risk TLS patients, including aggressive fluid management and rational use of diuretics and uric-acid-lowering drugs. In addition, this case confirms the effectiveness of CRRT for severe STLS.
摘要：
背景：肿瘤溶解综合征（TLS）是一种以代谢和电解质失衡为特征的血液肿瘤急症。关于肿瘤细胞的分解，大量的钾，磷酸盐,核酸被释放到体循环中。TLS主要发生在化疗期间。然而,在开始治疗前,罕见发生自发性肿瘤溶解综合征(STLS).
方法：在报告的病例中，这孩子刚刚做了活组织检查.当切口闭合时，突然高烧,心律失常,严重的高钾血症,低钙血症,和酸中毒。在及时对症治疗和连续肾脏替代疗法（CRRT）后，孩子的实验室结果有所改善，器官功能恢复正常。最终病理诊断为Burkitt淋巴瘤。这个男孩目前正在接受维持化疗。
结论：TLS是一种潜在的危及生命的血液肿瘤并发症。从这个案例中可以得出几个重要的结论,提醒临床医生:(1)充分了解TLS的危险因素,评估风险水平;(2)术中注意STLS的可能性,如果必须进行外科手术，并且在最小的创伤和最短的时间内进行手术；（3）对高危TLS患者积极进行术前预防，包括积极的液体管理和合理使用利尿剂和降尿酸药物。此外,该病例证实了CRRT治疗严重STLS的有效性.
方法：在报告的病例中，这孩子刚刚做了活组织检查.当切口闭合时，突然高烧,心律失常,严重的高钾血症,低钙血症,和酸中毒。在及时对症治疗和连续肾脏替代疗法（CRRT）后，孩子的实验室结果有所改善，器官功能恢复正常。最终病理诊断为Burkitt淋巴瘤。这个男孩目前正在接受维持化疗。
结论：TLS是一种潜在的危及生命的血液肿瘤并发症。从这个案例中可以得出几个重要的结论,提醒临床医生:(1)充分了解TLS的危险因素,评估风险水平;(2)术中注意STLS的可能性,如果必须进行外科手术，并且在最小的创伤和最短的时间内进行手术；（3）对高危TLS患者积极进行术前预防，包括积极的液体管理和合理使用利尿剂和降尿酸药物。此外,该病例证实了CRRT治疗严重STLS的有效性.
