title: Tumor lysis syndrome associated with reduced immunosuppression in a lung transplant recipient.
abstract: Tumor lysis syndrome usually occurs after Initiation of chemotherapy or radiation therapy in cancer patients with a moderate to high tumor burden. To our knowledge, the occurrence of this syndrome after discontinuation or reduction of an immunosuppressive regimen has not been reported in the literature. We describe a patient who had undergone lung transplantation and who was receiving immunosuppression and experienced an episode of acute pancreatitis. During the course of the work-up, the patient was found to have a B-cell lymphoma (posttransplantation lymphoproliferative disease). His tacrolimus dosage was decreased, and azathioprine was discontinued. The patient subsequently developed tumor lysis syndrome. Other than the decrease in immunosuppression, we found no other factor that could have accounted for this syndrome.
authors.affiliation: Division of Nephrology, OPW 526, Indiana University, 1001 W 10th St, Indianapolis, IN 46202, USA.
authors.forename: Behram A
authors.initials: BA
authors.lastname: Khan
authors.forename: Conrad
authors.initials: C
authors.lastname: Deel
authors.forename: Richard N
authors.initials: RN
authors.lastname: Hellman
mesh_terms: D000368:Aged; D001379:Azathioprine / Q000008:administration & dosage / Q000009:adverse effects; D017809:Fatal Outcome; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000150:complications*; D008297:Male; D013375:Substance Withdrawal Syndrome; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects; D015275:Tumor Lysis Syndrome / Q000175:diagnosis / Q000209:etiology*
chemical_list: D007166:Immunosuppressive Agents; D001379:Azathioprine; D016559:Tacrolimus