title: Dexamethasone-induced tumor lysis syndrome in high-grade non-Hodgkin's lymphoma.
abstract: 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.
authors.affiliation: Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: I A
authors.initials: IA
authors.lastname: Malik
authors.forename: S
authors.initials: S
authors.lastname: Abubakar
authors.forename: F
authors.initials: F
authors.lastname: Alam
authors.forename: A
authors.initials: A
authors.lastname: Khan
mesh_terms: 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*
chemical_list: D003907:Dexamethasone