What is the pathophysiology of tumor lysis syndrome?
The pathophysiology involves massive tumor cell lysis resulting in the release of large amounts of potassium, phosphate, and uric acid. Deposition of uric acid and calcium phosphate crystals in the renal tubules may lead to acute renal failure, which is often exacerbated by concomitant intravascular volume depletion.
What happens in tumor lysis syndrome?
Tumor lysis syndrome refers to the constellation of metabolic disturbances that occurs when large numbers of neoplastic cells are killed rapidly, leading to the release of intracellular ions and metabolic byproducts into the systemic circulation.
Why does TLS cause hypocalcemia?
Hypocalcemia in TLS has been attributed to intracellular phosphate forming complexes with free calcium after it is released into the blood stream . Hypocalcemia can cause muscle cramps, tetany and seizures. It may also cause QT prolongation and impairment of cardiac contractility.
What causes TLS?
When cancer cells break down quickly in the body, levels of uric acid, potassium, and phosphorus rise faster than the kidneys can remove them. This causes TLS. Excess phosphorus can “sop up” calcium, leading to low levels of calcium in the blood.
Why is LDH elevated in tumor lysis syndrome?
An increase in lactate dehydrogenase (LDH) is typically seen in patients with TLS, probably because of anaerobic glucose metabolism. However, the elevation of LDH is not included in the laboratory definition of LDH and it is important to note that LDH is a very sensitive but quite nonspecific marker for TLS.
Why is calcium low in Tumour lysis syndrome?
Why is calcium low in TLS?
Does TLS cause hypercalcemia?
Tumor lysis syndrome (TLS) is characterized by hyperkalemia, hyperuricemia, hypocalcemia and hyperphosphatemia. This report describes a case of hypercalcemia in TLS in a patient with diffuse large B cell lymphoma.
What is TLS and how does it present biochemically?
Core tip: Tumor lysis syndrome (TLS) is characterized by a massive tumor cell death leading to the development of metabolic derangements and target organ dysfunction. TLS can occur as a result of cancer treatment or spontaneously.