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Spontaneous Tumor Lysis Syndrome Presenting Acute Kidney Injury with Extreme Hyperuricemia and Urinary Stone: A Rare Case of Spontaneous Tumor Lysis Syndrome

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주제분류소아과학

초록

Tumor lysis syndrome is a serious complication of malignancy, resulting from the massive and rapid release of cellular components into the blood. Generally, it occurs after initiation of chemotherapy. The onset of spontaneous tumor lysis syndrome (STLS) before anti-cancer treatment is rare and occurs mostly in Burkitt lymphoma and non-Hodgkin’s lymphoma. There are only a few case reports in children. Here, we report a case of STLS secondary to T-cell acute lymphoblastic leukemia (ALL), which presented with urinary stone and subsequent acute kidney injury with severe hyperuricemia. Occult malignancy should be considered in case of unexplained acute kidney injury with extreme hyperuricemia.

Abstract

Tumor lysis syndrome is a serious complication of malignancy, resulting from the massive and rapid release of cellular components into the blood. Generally, it occurs after initiation of chemotherapy. The onset of spontaneous tumor lysis syndrome (STLS) before anti-cancer treatment is rare and occurs mostly in Burkitt lymphoma and non-Hodgkin’s lymphoma. There are only a few case reports in children. Here, we report a case of STLS secondary to T-cell acute lymphoblastic leukemia (ALL), which presented with urinary stone and subsequent acute kidney injury with severe hyperuricemia. Occult malignancy should be considered in case of unexplained acute kidney injury with extreme hyperuricemia.

참고문헌 (10)

  1. Howard SC, "The tumor lysis syndrome", N Engl J Med, 364, pp.1844~1854 (2011)
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  3. Cohen LF, "Acute tumor lysis syndrome. A review of 37 patients with Burkitt’s lymphoma", Am J Med, 68, pp.486~491 (1980)
  4. Hsu HH, "Acute spontaneous tumor lysis presenting with hyperuricemic acute renal failure: clinical features and therapeutic approach", J Nephrol, 17, pp.50~56 (2004)
  5. Daly GF, "Renal Calculi: An Unusual Presentation of T-Cell Acute Lymphoblastic Leukemia", Pediatrics, 137 (2016)
  6. Chen RL, "Transient spontaneous remission after tumor lysis syndrome triggered by a severe pulmonary infection in an adolescent boy with acute lymphoblastic leukemia", J Pediatr Hematol Oncol, 31, pp.76~79 (2009)
  7. Lotfi M, "Spontaneous acute tumor lysis syndrome in acute myeloid leukemia? A single case report with discussion of the literature", Leuk Lymphoma, 29, pp.625~628 (1998)
  8. Davidson MB, "Pathophysiology, clinical consequences, and treatment of tumor lysis syndrome", Am J Med, 116, pp.546~554 (2004)
  9. Wilson FP, "Onco-nephrology: tumor lysis syndrome", Clin J Am Soc Nephrol, 7, pp.1730~1739 (2012)
  10. Schlick K, "Spontaneous tumor lysis syndrome presenting as acute renal failure in an adult with de novo aleukemic T-ALL:value of renal biopsy?", J Clin Oncol, 29, pp.e494~e496 (2011)

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