title: Tumor lysis syndrome: risk factors, diagnosis, and management.
abstract: Tumor lysis syndrome (TLS) is a potentially fatal complication of induction therapy for several types of malignancies. Electrolyte derangements and even downstream complications may also occur prior to the initial presentation to a medical provider, before an oncologic diagnosis has been established. It is therefore imperative that emergency physicians be familiar with the risk factors for TLS in children as well as the criteria for diagnosis and the strategies for prevention and management. Careful evaluation of serum electrolytes, uric acid, and renal function must occur. Patients at risk for TLS and those who already exhibit laboratory or clinical evidence of TLS require close monitoring, aggressive hydration, and appropriate medical treatment.
authors.affiliation: Assistant Professor (Burns), *Division of *Emergency Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA; Assistant Professor of Pediatrics (Topoz), †Section of Emergency Medicine, Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO; Medical Director, ‡Emergency Department and Associate Professor of Pediatrics (Reynolds) Division of Pediatric Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Chicago, IL.
authors.forename: Rebekah A
authors.initials: RA
authors.lastname: Burns
authors.forename: Irina
authors.initials: I
authors.lastname: Topoz
authors.forename: Sally L
authors.initials: SL
authors.lastname: Reynolds
mesh_terms: D000493:Allopurinol / Q000627:therapeutic use; D002051:Burkitt Lymphoma / Q000175:diagnosis / Q000188:drug therapy*; D002648:Child; D003404:Creatinine / Q000097:blood; D004573:Electrolytes / Q000097:blood; D005440:Fluid Therapy; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D018570:Risk Assessment; D012307:Risk Factors; D015275:Tumor Lysis Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D014503:Urate Oxidase / Q000627:therapeutic use; D014527:Uric Acid / Q000097:blood
chemical_list: D004573:Electrolytes; D006074:Gout Suppressants; C469709:rasburicase; D014527:Uric Acid; D000493:Allopurinol; D003404:Creatinine; D014503:Urate Oxidase