Spontaneous tumor lysis syndrome in a child with T‐cell acute lymphoblastic leukemia

Kobayashi, Daisuke; Wofford, Marcia M.; McLean, Thomas W.; Lin, Jen Jar

doi:10.1002/pbc.22384

Cited by 29 publications

(18 citation statements)

References 13 publications

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“…1,5 STLS describes the same constellation of laboratory abnormalities before the initiation of chemotherapy, which has only rarely been described in the pediatric literature. 3,4 The initial presentation of hyperphosphatemia, hyperkalemia, metabolic acidosis, hyperuricemia with concomitant renal calculi, ARF, and the subsequent diagnosis of T-cell ALL in our patient is consistent with STLS. STLS has been described more frequently in adult populations with hematologic malignancy (most commonly Burkitt lymphoma) 1,6 ; our case is the second to be reported in this age group of ≤6 years.…”

Section: Discussionmentioning

confidence: 53%

“…Kobayashi et al described a 5-year-old female patient with STLS and T-cell ALL who presented with acute azotemia in the setting of recurrent urinary tract infections. 3 Our case is the first to describe gross hematuria and renal stones from STLS in the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 There is a single reported case of STLS secondary to T-cell acute lymphoblastic leukemia (ALL) in the under 6 years age group. 3 However, our case is the first description of pediatric STLS presenting with gross hematuria and renal calculi.…”

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confidence: 88%

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Renal Calculi: An Unusual Presentation of T-Cell Acute Lymphoblastic Leukemia

2016

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Spontaneous tumor lysis syndrome is a rare initial presentation of hematologic malignancy in children that typically presents with complications of electrolyte derangement, specifically hyperkalemia, hyperphosphatemia, and hyperuricemia. We report a case of a 5-year-old boy who presented to the emergency department with gross hematuria, abdominal pain, and vomiting and was ultimately diagnosed with uric acid nephrolithiasis and acute renal failure secondary to spontaneous tumor lysis syndrome in the setting of T-cell acute lymphoblastic leukemia. Tumor lysis syndrome is considered an oncologic emergency, and in this case, the child required urgent treatment with potassium-binding agents, rasburicase, and hemodialysis. This case demonstrates that occult hematologic malignancy should be suspected in cases of nephrolithiasis and acute renal failure when found in conjunction with hyperuricemia despite a normal complete blood count at the time of presentation.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

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Renal Calculi: An Unusual Presentation of T-Cell Acute Lymphoblastic Leukemia

2016

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“…There were several reports of spontaneous TLS in pediatric patients with ALL, T-ALL, AML, and non-Hodgkin's lymphoma. [7,[12][13][14] Of interest is that patients with ALL or T-ALL had normal peripheral white blood cell counts without any blasts in their smears. [7,13] Hyperuricemia is apparently one of the cardinal manifestations of TLS.…”

Section: Discussionmentioning

confidence: 99%

Hyperuricemia in Pediatric Malignancies Before Treatment

Nagai

Kubota

et al. 2011

Nucleosides, Nucleotides and Nucleic Acids

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The objective of this study was to clarify the prevalence and characteristics of hyperuricemia in various pediatric malignancies before the initiation of treatment. We conducted a retrospective analysis of 119 children with various newly diagnosed malignancies between April 2000 and March 2010. On the basis of the reference values previously established in our laboratory, hyperuricemia was defined as uric acid (UA) levels above 2 standard deviations (s.d.) over the mean values at each age. Thirty-six patients (30.3%) showed hyperuricemia. Hyperuricemia was more common in male patients (36.8%) than in female patients (21.6%). The prevalence of hyperuricemia was highest in patients with lymphoma followed by those with acute lymphoblastic leukemia (ALL). When the study population was divided into hyperuricemia-negative and -positive populations, blood urea nitrogen, creatinine, and lactate dehydrogenase levels, and white blood cell counts (only in leukemia) were found to be significantly higher in the latter group by a univariate analysis. This study highlights useful information for identifying patients with malignancies at risk for tumor lysis syndrome (TLS) before starting chemotherapy.

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“…It is often seen in solid tumours with high cell load like Burkitt lymphoma or acute leukaemia with high cell load 10. A retrospective study from Taiwan showed that 1.1% of acute renal failure in adults were as a result of spontaneous tumour lysis presenting with acute renal failure, elevated LDH and hyperuricaemia.…”

Section: Discussionmentioning

confidence: 99%

Tumour lysis in newborn: spontaneous or secondary to antenatal steroids?

Ponmudi

Beryl

Santhanam³

et al. 2018

BMJ Case Reports

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Malignancies are rare in the early neonatal period. Common congenital tumours include malignant teratoma and neuroblastomas. Tumour lysis syndrome is a serious condition usually seen after commencement of chemotherapy for a malignancy. Rare case reports of spontaneous tumour lysis have been reported though not in the newborn period. We report here an instance of tumour lysis syndrome in a newborn with congenital rhabdoid tumour, where the cause was either spontaneous or related to antenatal steroid exposure.

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Spontaneous tumor lysis syndrome in a child with T‐cell acute lymphoblastic leukemia

Cited by 29 publications

References 13 publications

Renal Calculi: An Unusual Presentation of T-Cell Acute Lymphoblastic Leukemia

Renal Calculi: An Unusual Presentation of T-Cell Acute Lymphoblastic Leukemia

Hyperuricemia in Pediatric Malignancies Before Treatment

Tumour lysis in newborn: spontaneous or secondary to antenatal steroids?

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