title: A tumour lysis syndrome in a chemotherapy naïve patient with metastatic pancreatic adenocarcinoma.
abstract: A 56-year-old woman with a new diagnosis of metastatic pancreatic cancer presents to the emergency room with generalised fatigue. The patient is afebrile, however, hypotensive and tachycardic. Physical examination shows diffuse lymphadenopathy. Initial laboratory tests indicate that the patient has hyperkalaemia, hypocalcaemia, with a high lactate dehydrogenase and high uric acid. The patient was also in renal failure. On the basis of the clinical presentation, the patient was diagnosed with spontaneous tumour lysis syndrome, despite the syndrome never having been reported in metastatic pancreatic cancer. The patient was treated appropriately with intravenous hydration, allopurinol and rasburicase. All laboratory abnormalities were corrected by day 3 of treatment.
authors: Department of Internal Medicine, McGill University, Montreal, Canada.
authors: Ramy R
authors: RR
authors: Saleh
authors: Department of Internal Medicine, McGill University, Montreal, Canada.
authors: Jennifer
authors: J
authors: Rodrigues
authors: Department of Internal Medicine, McGill University, Montreal, Canada.
authors: Todd C
authors: TC
authors: Lee
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000556:secondary*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D015275:Tumor Lysis Syndrome / Q000175:diagnosis* / Q000628:therapy*
references: Clin J Am Soc Nephrol. 2007 Jan;2(1):16-21
references: 17699382
references: Am J Med. 2004 Apr 15;116(8):546-54
references: 15063817
references: Am J Hematol. 1994 Oct;47(2):129-31
references: 8092128
references: Clin Genitourin Cancer. 2014 Oct;12(5):e225-7
references: 24999167
references: Br J Haematol. 2004 Oct;127(1):3-11
references: 15384972
references: Cancer Chemother Pharmacol. 2003 Mar;51(3):187-92
references: 12655435
references: N Engl J Med. 2011 May 12;364(19):1844-54
references: 21561350
references: Br J Haematol. 2010 May;149(4):578-86
references: 20331465
references: CMAJ. 2012 May 15;184(8):913-6
references: 22496380
references: Pancreas. 2012 May;41(4):659-61
references: 22504387
references: Am J Clin Oncol. 1994 Dec;17(6):502-5
references: 7977169