Summary
Definition
History and exam
Key diagnostic factors
- neoplasia hematológica
- tratamento para o câncer recente (particularmente quimioterapia)
- comprometimento renal preexistente
- arritmia cardíaca (incluindo síncope, dor torácica, dispneia)
- convulsões
Other diagnostic factors
- náuseas e vômitos
- anorexia
- diarreia
- fraqueza muscular
- paralisia
- cãibras e espasmos musculares
- letargia
- parestesia
- linfadenopatia
- esplenomegalia
- hipertensão/hipotensão
- oligúria/anúria/hematúria
- urina turva
- dor/desconforto articular
- malignidade de tumor sólido
- tetania
- sinal de Trousseau
- sinal de Chvostek
- laringoespasmo
- edema periférico ou pulmonar
- confusão/delirium/alucinações
- dor no flanco
Risk factors
- neoplasia hematológica
- grande carga tumoral
- tumores sensíveis ao tratamento
- tratamento para o câncer recente (particularmente quimioterapia)
- comprometimento renal preexistente
- desidratação
- depleção de volume
- uso de agentes nefrotóxicos
- idade avançada
Diagnostic investigations
1st investigations to order
- ácido úrico sérico
- fosfato sérico
- potássio sérico
- cálcio sérico
- Hemograma completo
- lactato desidrogenase (LDH) sérica
- creatinina sérica
- ureia sérica
- pH da urina
Investigations to consider
- eletrocardiograma (ECG)
Treatment algorithm
baixo risco
médio risco
alto risco
síndrome da lise tumoral (SLT) clínica ou laboratorial
Contributors
Authors
Tariq Mughal, MD, FRCP, FACP, FRCPath
Clinical Professor of Medicine
Tufts University Cancer Center
Boston
MA
Disclosures
TM declares that he has no competing interests. TM is an author of an article cited in the topic.
Acknowledgements
Professor Tariq Mughal would like to gratefully acknowledge Dr James Larkin and Dr Anastasia Constantinidou, previous contributors to this topic.
Disclosures
JL and AC declare that they have no competing interests.
Peer reviewers
Shereen Ezzat, MD
Professor of Medicine and Oncology
University of Toronto
Toronto
Ontario
Canada
Disclosures
SE declares that he has no competing interests.
David Landau, MB BS, MRCP, FRCR
Consultant Clinical Oncologist
Guy's & St. Thomas' NHS Trust
Honorary Senior Lecturer
Imaging Sciences Division
King's College Hospital
London
UK
Disclosures
DL declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Coiffier B, Altman A, Pui CH, et al. Guidelines for the management of pediatric and adult tumor lysis syndrome: an evidence-based review. J Clin Oncol. 2008 Jun 1;26(16):2767-78. Abstract
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: B-cell lymphomas [internet publication].Full text
Jones GL, Will A, Jackson GH, et al. Guidelines for the management of tumour lysis syndrome in adults and children with haematological malignancies on behalf of the British Committee for Standards in Haematology. Br J Haematol. 2015 Jun;169(5):661-71.Full text Abstract
Cairo MS, Coiffier B, Reiter A, et al. Recommendations for the evaluation of risk and prophylaxis of tumour lysis syndrome (TLS) in adults and children with malignant diseases: an expert TLS panel consensus. Br J Haematol. 2010 May;149(4):578-86.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Hiperuricemia isolada
- Hipercalemia isolada
- Hiperfosfatemia isolada
More DifferentialsGuidelines
- NCCN clinical practice guidelines in oncology: B-cell lymphomas
- NCCN clinical practice guidelines in oncology: chronic lymphocytic leukemia/small lymphocytic lymphoma
More Guidelines
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer