title: Massive uric acid nephrolithiasis with progressive renal failure due to spontaneous tumour lysis syndrome.
abstract: Tumour lysis syndrome (TLS) is a constellation of meta- bolic complications due to the rapid destruction of malignant cells, causing renal, cardiac or cerebral dysfunction. Electrolyte abnormalities include hyperuricaemia, hyperphosphataemia, hyperkalaemia and hypocalcaemia. TLS-induced renal failure is mainly caused by uric acid and calcium phosphate crystal deposition and usually develops following cytotoxic chemotherapy. Here, we present a case of spontaneous TLS in a patient with chronic myelomonocytic leukaemia (CMML) with massive uric acid stone and crystal formation and rapidly worsening renal failure. Autopsy revealed underlying tumourous kidney infiltration. Risk factors for occurrence of TLS and current therapeutic management are discussed.
authors.affiliation: Clinic for Nephrology.
authors.forename: Johannes
authors.initials: J
authors.lastname: Trachsler
authors.affiliation: Department of Pathology.
authors.forename: Ariana
authors.initials: A
authors.lastname: Gaspert
authors.affiliation: Medical Intensive Care Unit, University Hospital/Zürich Medical School, Zürich , Switzerland.
authors.forename: Marco
authors.initials: M
authors.lastname: Previsdomini
authors.affiliation: Clinic for Nephrology.
authors.forename: Rudolf P
authors.initials: RP
authors.lastname: Wüthrich
authors.affiliation: Clinic for Nephrology.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fehr
keywords: acute renal failure; therapy; tumour lysis syndrome; uric acid nephrolithiasis