Dexamethasone-induced tumor lysis syndrome in high-grade non-Hodgkin's lymphoma.
Tumor lysis syndrome is a catastrophic complication of the treatment of certain neoplasms. It most commonly occurs in association with hematologic malignancies and manifests a few hours to a few days after initiation of specific chemotherapy. It has rarely been encountered as a complication of steroid therapy only. Tumor lysis syndrome is a potentially fatal condition if it is not recognized promptly and managed aggressively. We report on a patient with high-grade non-Hodgkin's lymphoma who developed severe metabolic acidosis, hyperkalemia, hyperphosphatemia, and hypocalcemia within 2 days of starting corticosteroid therapy. He was managed with intravenous fluids, bicarbonate infusion, calcium gluconate, and 25% dextrose with insulin. He did not respond to these measures and died within a few hours of the diagnosis of tumor lysis syndrome. Increasing awareness of this complication and proper prophylactic measures are necessary to improve the outcome.
Malik
I A
IA
Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
Abubakar
S
S
Alam
F
F
Khan
A
A
D000328:Adult; D003907:Dexamethasone / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D011379:Prognosis; D015275:Tumor Lysis Syndrome / Q000175:diagnosis / Q000209:etiology*
D003907:Dexamethasone