Tumor lysis is most commonly seen in Burkitt’s lymphoma and other hematologic malignancies after initiation of cytotoxic chemotherapy
Spontaneous tumor lysis is rare
Risk factors for TLS include chemosensitive malignancies, bulky Dz > 10 cm, pretreatment hyperuricemia, and dehydration
Evaluation of the calcium, phosphorous, uric acid level, and potassium levels are the first step in diagnosis
Treatment consists of intravenous fluids, uric acid lowering agents, and possibly dialysis
Allopurinol decreases production of uric acid while rasburicase shunts uric acid into allantoin to minimize uric acid precipitation in the renal tubules
Can’t use Rasburicase in patients with G6PD deficiency
Stages of hyperkalemia
> 5.5 peaked Ts
>6.5 atrial paralysis –> p wave widens/flattens, prolonged PR, then P’s disappear
> 7.0 conduction abnormalities, bradycardia, wide QRS with bizzare morphology, sine wave
