title: Low-dose steroid-induced tumor lysis syndrome in a hepatocellular carcinoma patient.
abstract: Tumor lysis syndrome is rare in hepatocellular carcinoma (HCC), but it has been reported more frequently recently in response to treatments such as transcatheter arterial chemoembolization (TACE), radiofrequency thermal ablation (RFTA), and sorafenib. Tumor lysis syndrome induced by low-dose steroid appears to be very unusual in HCC. We report a patient with hepatitis-C-related liver cirrhosis and HCC in whom tumor lysis syndrome occurred due to low-dose steroid (10 mg of prednisolone). The patient was a 90-year-old male who presented at the emergency room of our hospital with general weakness and poor oral intake. He had started to take prednisolone to treat adrenal insufficiency 2 days previously. Laboratory results revealed hyperuricemia, hyperphosphatemia, and increased creatinine. These abnormalities fulfilled the criteria in the Cairo-Bishop definition of tumor lysis syndrome. Although the patient received adequate hydration, severe metabolic acidosis and acute kidney injury progressed unabated. He finally developed multiple organ failure, and died 3 days after admission. This was a case of tumor lysis syndrome caused by administration of low-dose steroid in a patient with HCC.
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Jin Ok
authors.initials: JO
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Dae Won
authors.initials: DW
authors.lastname: Jun
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Tae
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Kang Nyeong
authors.initials: KN
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Hang Lak
authors.initials: HL
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Oh Young
authors.initials: OY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Ho Soon
authors.initials: HS
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Joon Soo
authors.initials: JS
authors.lastname: Hahm
mesh_terms: D058186:Acute Kidney Injury / Q000473:pathology; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000628:therapy; D016461:Chemoembolization, Therapeutic; D003404:Creatinine / Q000097:blood; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy*; D008297:Male; D009536:Niacinamide / Q000031:analogs & derivatives / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use; D000077157:Sorafenib; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D015275:Tumor Lysis Syndrome / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D013256:Steroids; D009536:Niacinamide; D000077157:Sorafenib; D003404:Creatinine
keywords: Hepatocellular carcinoma; Steroid; Tumor lysis syndrome
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