title: Spontaneous tumour lysis syndrome associated with contrast dye iohexol use in mantle cell lymphoma.
abstract: We describe a case of a 73-year-old man who presented with right-sided abdominal pain associated with palpable mass. Initial laboratory examination was normal except lactate dehydrogenase level. Subsequent CT image showed situs inversus and splenic mass with multiple lymph nodes enlargement. Biopsy taken from the splenic mass demonstrated mantle cell lymphoma. Staging CT examination was performed with intravenous contrast, and patient developed altered mental status, respiratory failure and acute kidney injury requiring intensive care unit care. Laboratory examination revealed hyperuricaemia, hyperphosphataemia, hyperkalaemia and hypocalcaemia, which are consistent with spontaneous tumour lysis syndrome. The patient was successfully treated with rasburicase and haemodialysis, and completed the first course of chemotherapy without further complications.
authors.affiliation: Department of Internal Medicine, University of Arizona Medical Center, Tucson, Arizona, USA.
authors.forename: Seongseok
authors.initials: S
authors.lastname: Yun
authors.affiliation: College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Nicole D
authors.initials: ND
authors.lastname: Vincelette
authors.affiliation: Department of Internal Medicine, University of Arizona Medical Center, Tucson, Arizona, USA.
authors.forename: Tuan
authors.initials: T
authors.lastname: Phan
authors.affiliation: Department of Hematology, Oncology, Blood Marrow Transplantation, University of Arizona Medical Center, Tucson, Arizona, USA.
authors.forename: Faiz
authors.initials: F
authors.lastname: Anwer
mesh_terms: D000368:Aged; D001706:Biopsy; D003287:Contrast Media / Q000009:adverse effects; D003937:Diagnosis, Differential; D006801:Humans; D007472:Iohexol / Q000009:adverse effects*; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis*; D008297:Male; D006435:Renal Dialysis; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000379:methods*; D015275:Tumor Lysis Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
chemical_list: D003287:Contrast Media; D007472:Iohexol