Tumor lysis syndrome causes all EXCEPT:
Correct Answer: Hypercalcemia
Description: ANSWER: (A) HypercalcemiaREF: Harrison's 18th ed chapter 276,figure 276-4Repeat from Primary DNB CET December 2011Tumor lysis syndrome (TLS) is characterized by hyperuricemia, hyperkalemia, hypermagnesemia, hyperphosphatemia, and hypocalcemia and is caused by the destruction of a large number of rapidly proliferating neoplastic cells. Acidosis may also develop. Acute renal failure occurs frequently.TLS is most often associated with the treatment of Burkitt's lymphoma, acute lymphoblastic leukemia, and other rapidly proliferating lymphomas, but it also may be seen with chronic leukemias and, rarely, with solid tumor. TLS usually occurs during or shortly (1-5 days) after chemotherapyTreatment:Recognition of risk and prevention are the most important steps in the management of this syndrome. The standard preventive approach consists of allopurinol, urinary alkalinization, and aggressive hydration. Intravenous allopurinol may be given in patients who cannot tolerate oral therapy. Rasburicase (recombinant urate oxidase) can be effective where uric acid levels can t be reduced by standard methods.Indications of hemodialysis in TLS:Serum K > 6 mEq/ISerum creatinine > 10 mg/dlSerum phosphate >10 mg/dl or increasingSymptomatic hypocalcemia.
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