Systemic Inflammatory Response Syndrome and Multiple Organ Dysfunction in Patients with Acute Tumor Lysis Syndrome

Soares, Márcio; Feres, Guilherme Alvarenga; Salluh, Jorge I.

doi:10.1590/s1807-59322009000500016

Cited by 46 publications

(32 citation statements)

References 13 publications

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“…Other acute clinical manifestations include cardiac arrhythmias and neurological abnormalities. Furthermore, tumour lysis syndrome may be complicated by systemic inflammatory response syndrome,9 a non-specific systemic response, triggered by a number of cellular, humoral and biochemical mediators. Both syndromes may lead to multiple organ failure, thereby increasing the risk of death.…”

Section: Discussionmentioning

confidence: 99%

Acute onset and rapid progression of multiple organ failure in a young adult with undiagnosed disseminated colonic adenocarcinoma

2014

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Colourectal cancer (CRC) is the fourth most common cause of death from cancer worldwide. While rates for CRC in adults age 50 and older have been declining, incidence rates in young adults, a population routinely not screened, has been increasing. We report a rare case of high-grade CRC in a previously healthy 27-year-old man, presented to us with symptoms of increasing abdominal pain and distension. Extensive diagnostic investigation revealed hepatomegaly with multiple processes, signs of vasculitis, extensive liver necrosis, enlarged retroperitoneal and mesenteric lymph nodes, splenomegaly, ascites and multiple vein thrombosis. The patient passed away shortly after admission due to treatment-resistant tumour lysis syndrome and multiple organ failure. Biopsy results revealed disseminated adenocarcinoma of the colon, with metastases to lymph nodes, liver, lungs and pleura. CRC in younger patients tend to present at a later stage and appears to be more aggressive, with a poorer pathological differentiation.

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Section: Discussionmentioning

confidence: 99%

Acute onset and rapid progression of multiple organ failure in a young adult with undiagnosed disseminated colonic adenocarcinoma

2014

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“…SIRS and MOD associated with acute spontaneous tumor lysis syndrome (ATLS) would seem to be physiologically plausible. Soares et al [12] in a retrospective, small study reported five patients who developed ATLS associated with SIRS and MOD in the absence of clear alternative explanations. The etiology of systemic inflammatory response syndrome in tumor lysis syndrome patients is not fully understood; it is reasonable to hypothesize that cytokines released by the cells during lysis may induce severe SIRS and often multiorgan failure.…”

Section: Discussionmentioning

confidence: 99%

Concurrent acute spontaneous tumor lysis syndrome complicated with multiple organ failure in a patient with pre-existing undiagnosed lung cancer

Amiri

2015

CEN Case Rep

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Acute kidney injury, a common complication associated with malignancy, occurs in various clinical situations for numerous reasons. Acute tumor lysis syndrome (TLS) is possibly the most significant cause of acute kidney injury in cancer patients, because it is fulminant at onset and associated with severe metabolic derangements. Acute spontaneous tumor lysis syndrome is rare and most of the related malignancies belong to hematologic malignancies but it has seldom been investigated as bulky or advanced metastatic non-hematologic malignancies. TLS comprises a clinical laboratory derangement of cellular metabolism which can lead to acute renal impairments, cardiac arrhythmia, seizures and patient demise. Prevention and treatment of tumor lysis syndrome depends on early recognition of at-risk patients, volume repletion and xanthin oxidase inhibitors. In addition, in patients with high risk tumor types, prophylactic use of rasburicase before chemotherapy is required. If dialysis is required, continuous modalities may be favored, particularly in patients with more severe TLS. This case report discusses a 79-year-old man with controlled Alzheimer's disease presented with picture of septic shock and multiorgan dysfunction (acute kidney injury, acute lung injury, acute brain injury) pulmonary suppuration in the right lung field due to aspiration pneumonia with infection-induced systemic inflammatory response (SIRS) was diagnosed. Further workup revealed lung cancer on chest CT scan. Antibiotic, respirator and hemodialysis treatment improved his condition but died several days later. Acute spontaneous TLS may present in association with infectious SIRS and multiple organ failure, the combination of which results in significant mortality.

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Section: Introductionmentioning

confidence: 99%

“…The release of these intracellular contents cause metabolic disturbances, which in turn manifest into life threatening complications such as hyperkalemia, hyperphosphotemia, hypocalcemia and hyperuricemia. Tumour lysis also releases cytokines that cause a systemic inflammatory response syndrome and often multiorgan failure (Hijiya et al, 2005;Nakamura et al, 2009;Soares et al, 2009).During the early stages, some patients do not experience any symptoms of TLS but have abnormal laboratory values, which is suggestive of its succession. Laboratory results will show high potassium, uric acid and phosphorus levels and low calcium levels in the blood.…”

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confidence: 99%

Tumour Lysis Syndrome: Implications for Cancer Therapy

Mika¹,

Ahmad²,

Guruvayoorappan³

2012

Asian Pacific Journal of Cancer Prevention

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Asian Pacific J Cancer Prev, 13, 3555-3560 IntroductionTumour lysis syndrome (TLS) is the development of an array of metabolic disturbances that may occur either spontaneously or in response to cancer therapies. It results when a huge number of rapidly dividing cancer cells, particularly leukemia and lymphoma, are killed or lysed by cytotoxic therapy such as chemotherapy and radiation. Normal intracellular components of cells include potassium, phosphorus and nucleic acids. These intracellular ions are present in large amounts in cancer cells as compared to those in normal cells.When malignant cells are killed by therapy they release their contents into the systemic circulation, which accumulate faster in the body than being eliminated from the body and the body's homeostatic mechanisms find it difficult to cope with. The release of these intracellular contents cause metabolic disturbances, which in turn manifest into life threatening complications such as hyperkalemia, hyperphosphotemia, hypocalcemia and hyperuricemia. Tumour lysis also releases cytokines that cause a systemic inflammatory response syndrome and often multiorgan failure (Hijiya et al., 2005;Nakamura et al., 2009;Soares et al., 2009).During the early stages, some patients do not experience any symptoms of TLS but have abnormal laboratory values, which is suggestive of its succession. Laboratory results will show high potassium, uric acid and phosphorus levels and low calcium levels in the blood.

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Systemic Inflammatory Response Syndrome and Multiple Organ Dysfunction in Patients with Acute Tumor Lysis Syndrome

Cited by 46 publications

References 13 publications

Acute onset and rapid progression of multiple organ failure in a young adult with undiagnosed disseminated colonic adenocarcinoma

Acute onset and rapid progression of multiple organ failure in a young adult with undiagnosed disseminated colonic adenocarcinoma

Concurrent acute spontaneous tumor lysis syndrome complicated with multiple organ failure in a patient with pre-existing undiagnosed lung cancer

Tumour Lysis Syndrome: Implications for Cancer Therapy

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