Index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Home > Tumor lysis syndrome

In medicine ( oncology and hematology), tumor lysis syndrome is a complication of chemotherapy to particularly large tumors, e.g. bulky lymphomas. Breakdown products ( lysis) of the cancer cells enter the bloodstream; many are biochemically active substances.

1 Signs and symptoms

Acute gout, vomiting, weakness/malaise, decreased urine production, convulsions. Symptoms progress, leading to coma and death if untreated.

In patients who are being treated for massive lesions, prophylaxis with allopurinol may already have been given (see below).

2 Diagnosis

Blood tests done when tumor lysis syndrome is suspected generally include full blood count, renal function ( creatinine), electrolytes, blood urea nitrogen, uric acid, calciumSee also Calcium, New York, United States. potassium calcium scandium Mg Ca Sr Full table General Name, Symbol, Numbercalcium, Ca, 20 Series alkaline earth metal Group, Period, Block 2 (IIA), 4, s Density, Hardness 1550 kg/m3, 1. 75 Appearance silvery whi, phosphateIn chemistry, a phosphate is a polyatomic ion or radical consisting of one phosphorus atom and four oxygen. In the ionic form, it carries a -3 formal charge, and is denoted PO3-. In a biochemical setting, a free phosphate ion in solution is called inorgan, and albuminYou may be looking for albumen, or egg white. Albumin is a blood plasma protein that is produced in the liver and forms a large proportion of all plasma protein. The normal range of albumin concentrations in human blood is 3. 0 g/dL, and albumin normally (to correct calcium levels).

Tumor lysis syndrome features elevated uric acid (hence gout), potassium and phosphate and low calcium due to precipitation with the phosphate.

3 Pathogenesis

When compared to blood and extracellular fluidIn some animals, including mammals, the two types of extracellular fluid s are interstitial fluid and blood plasma. In humans, the normal glucose concentration of extracellular fluid that is regulated by homeostasis is approximately 5 mM. The pH of extrac, cellsstained for keratin The cell is the structural and functional unit of all living organisms. Some organisms, such as bacteria, are unicellular, consisting of a single cell. Other organisms, such as humans, are multicellular, (humans have an estimated 100,0 are relatively high in potassium and phosphates, as both are required for cellular function. High turnover of cells leads to an increase in these in the blood.

Uric acid is a breakdown product of DNADeoxyribonucleic acid DNA is a nucleic acid which carries genetic instructions for the biological development of all cellular forms of life and many viruses. DNA is sometimes referred to as the molecule of heredity as it is inherited and used to propagate, converted by xanthine oxidaseThe enzyme xanthine oxidase or XO (bovine milk enzyme is PDB , E. 22) catalyzes the oxidation of hypoxanthine to xanthine and can further catalyze the oxidation of xanthine to uric acid: hypoxanthine + O xanthine + HO xanthine + O + 2HO uric acid + 2HO Th from xanthine and hypoxanthine, which are in turn purineA purine is a bicyclic organic compound, consisting of a fused pyrimidine/ imidazole ring. Two of the bases in nucleic acids, adenine and guanine, are purines. In DNA, these bases form hydrogen bonds with their complementary pyrimidines thymine and cytosi breakdown producs. Uric acid is more toxic to tissues than (hypo)xanthine.

4 Prophylaxis and treatment

Follow-up of patients at risk consists of regular checking of urine production and blood pressure.

Patients with bulky lesions may require intravenous fluids (3 liters a day) and possibly allopurinol, an inhibitor of xanthine oxidase, which limits formation of uric acid. Elimination of waste products may possibly be accelerated by forced alkaline diuresis , e.g. administering bicarbonate to speed up urine production, and diuretics (but thiazides interfere with uric acid elimination and must be avoided).

In severe tumor lysis syndrome, individual abnormalities may need immediate treatment.

Hyperkalemia and high phosphate levels may eventually require dialysis
Hypocalcemia may require intravenous calcium gluconate and vitamin D3
High uric acid may respond to rasburicase, a synthetic urate oxidase enzyme. Its role in prophylaxis is undetermined.

5 See also

Chemotherapy

Oncology Hematology

<Hide>

Topics: Tumor Lysis Syndrome, Signs And Symptoms, Diagnosis...

Tumor suppressor geneA tumor suppressor gene is a gene that reduces the probability that a cell in a multicellular organism will turn into a tumor cell. A mutation or deletion of such a gene will increase the probability of a tumor. In that way, a tumor suppressor gene is sim	TumorTumor originally just meant "swelling", but the term is very often used to denote abnormal ( malignant or benign) growth of tissue. Malignant tumors ( cancer) invade and destroy neighboring tissues and can become metastatic. Benign tumors do not invade ne	Tumor necrosis factorIn medicine, tumor necrosis factor alpha (TNF, cachexin or cachectin) is an important cytokine involved in systemic inflammation and the acute phase response. Structure TNF is a member of a group of other cytokines that all stimulate the acute phase react
Tumor lysis syndromeIn medicine ( oncology and hematology), tumor lysis syndrome is a complication of chemotherapy to particularly large tumors, e. bulky lymphomas. Breakdown products ( lysis) of the cancer cells enter the bloodstream; many are biochemically active substance

Non User