54:
516:) should receive appropriate intravenous hydration in order to improve blood flow to the kidneys, maximize urine output, and ultimately prevent precipitation of uric acid crystals that can lead to acute kidney injury. A diuretic may also be indicated to further increase urine output in addition to intravenous hydration. Another approach to prevent damage to the kidneys is to prevent the buildup of uric acid during TLS, and this can be accomplished with use of
331:. This entity is associated with acute kidney failure due to uric acid nephropathy prior to the institution of chemotherapy and is largely associated with lymphoma and leukemia. The important distinction between this syndrome and the post-chemotherapy syndrome is that spontaneous TLS is not associated with hyperphosphatemia. One suggestion for the reason of this is that the high cell turnover rate leads to high uric acid levels through
293:. Massive cell death and nuclear breakdown generates large quantities of nucleic acids. Of these, the purines (adenine and guanine) are converted to uric acid via the purine degradation pathway and excreted in the urine. However, at the high concentrations of uric acid generated by tumor lysis, uric acid is apt to precipitate as
417:
TLS should be suspected in patients with large tumor burden who develop acute kidney failure along with hyperuricemia (> 15 mg/dL) or hyperphosphatemia (> 8 mg/dL). (Most other acute kidney failure occurs with uric acid < 12 mg/dL and phosphate < 6 mg/dL). Acute uric
546:
Monitoring potassium levels in the blood frequently and cardiac monitoring (given the risk of cardiac arrhythmias) are important components in the prevention of adverse consequences in TLS. Other strategies, such as limiting oral intake of potassium, and excreting potassium through the
485:
Two or more electrolyte laboratory abnormalities must be present simultaneously to be considered related to TLS. In fact, some patients may present with one abnormality, but later another one may develop that is unrelated to the TLS (e.g., hypocalcemia associated with
400:
Chemo-sensitive tumors, such as lymphomas, carry a higher risk for the development of tumor lysis syndrome. Those tumors that are more responsive to a chemotherapy agent carry a higher TLS risk. Usually, the precipitating medication regimen includes combination
501:
It is important to prevent life-threatening manifestations associated with TLS which include acute kidney injury, hyperkalemia (which may cause cardiac arrhythmias), and or hypocalcemia (which may cause cardiac arrhythmias and neuromuscular irritability).
359:
Tumors with a high cell turnover rate, rapid growth rate, and high tumor bulk tend to be more associated with the development of tumor lysis syndrome. The most common tumors associated with this syndrome are poorly differentiated lymphomas (such as
304:(AUAN) due to hyperuricosuria has been a dominant cause of acute kidney failure, but with the advent of effective treatments for hyperuricosuria, AUAN has become a less common cause than hyperphosphatemia. Two common conditions related to excess
647:
The rate of mortality from tumor lysis syndrome may vary widely depending on the type of underlying malignancy. However, the occurrence of acute kidney injury is concerning given the high mortality that is generally associated with it.
1155:... result in severe metabolic derangements (e.g., hyperuricemia, hypocalcemia, lactic acidosis, and the acute tumor lysis syndrome) which require expeditious management. Hyperuricemia Uric acid is the end product of purine catabolism.
422:
may show uric acid crystals or amorphous urates. The hypersecretion of uric acid can be detected with a high urine uric acid - creatinine ratio > 1.0, compared to a value of 0.6–0.7 for most other causes of acute kidney failure.
610:
may also be indicated to maintain appropriate production of urine by the kidneys. Further treatment is targeted towards the specific metabolic abnormalities present in patients with TLS (see "main articles" linked above). Mild
1606:
1591:
335:
turnover but the tumor reuses the released phosphate for growth of new tumor cells. In post-chemotherapy TLS, tumor cells are destroyed and no new tumor cells are being synthesized. TLS is most common during
573:
Hyperphosphatemia is a common finding in TLS, and high phosphorus levels can in turn contribute to hypocalcemia. Therefore, phosphate binders may be beneficial in preventing this form of hypocalcemia.
157:
therapy or from cancers with high cell turnover and tumor proliferation rates. The metabolic abnormalities seen in tumor lysis syndrome can ultimately result in serious complications such as
1359:"Guidelines for the management of tumour lysis syndrome in adults and children with haematological malignancies on behalf of the British Committee for Standards in Haematology"
118:
and should receive preventive measures and treatments as necessary. TLS can also occur on its own (while not being treated with chemotherapy) although this is less common.
198:. High turnover of tumor cells leads to spill of potassium into the blood. Symptoms usually do not manifest until levels are high (> 6.5 mmol/L) and they include
489:
A 25% change from baseline should not be considered a criterion since such increases are rarely clinically important unless the value is already outside the normal range.
785:"Recommendations for the evaluation of risk and prophylaxis of tumour lysis syndrome (TLS) in adults and children with malignant diseases: an expert TLS panel consensus"
851:
Coiffier B, Altman A, Pui CH, Younes A, Cairo MS (June 2008). "Guidelines for the management of pediatric and adult tumor lysis syndrome: an evidence-based review".
665:
Davidson MB, Thakkar S, Hix JK, Bhandarkar ND, Wong A, Schreiber MJ (April 2004). "Pathophysiology, clinical consequences, and treatment of tumor lysis syndrome".
353:
Risk factors for tumor lysis syndrome depend on several different characteristics of the patient, the type of cancer, and the type of chemotherapy used.
631:
may be given in cases of severe hyperkalemia. Concerning symptoms related to hypocalcemia (e.g. seizures) in TLS patients can be treated with
386:
Certain patient-related factors can affect the development of clinical tumor lysis syndrome. These factors include elevated baseline serum
1697:
508:
Patients at risk for developing TLS (e.g. patients about to receive chemotherapy for a cancer with a high cell turnover rate, especially
1215:"Spontaneous Tumor Lysis Syndrome: A Case Report and Critical Evaluation of Current Diagnostic Criteria and Optimal Treatment Regimens"
409:
treatment alone, and sometimes without any treatment—in this case the condition is referred to as "spontaneous tumor lysis syndrome".
246:
is precipitated to form calcium phosphate, leading to hypocalcemia. Symptoms of hypocalcemia include (but are not limited to):
114:. This is a potentially fatal complication and patients at increased risk for TLS should be closely monitored while receiving
1127:
998:
17:
532:
inhibitor, which inhibits uric acid production) works by preventing the formation of uric acid following tumor cell lysis.
149:
are a result of the release of cellular contents of dying cells into the bloodstream. In this respect, TLS is analogous to
1045:
Schafer AL, Shoback DM (2000), Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, et al. (eds.),
1141:
153:, with comparable mechanism and blood chemistry effects but with different cause. In TLS, the breakdown occurs after
438:: abnormality in two or more of the following, occurring within three days before or seven days after chemotherapy.
1702:
1133:
481:
In 2011, Howard proposed a refinement of the standard Cairo-Bishop definition of TLS accounting for 2 limitations:
473:
A grading scale (0–5) is used depending on the presence of lab TLS, serum creatinine, arrhythmias, or seizures.
1525:"In-Hospital Outcomes of Tumor Lysis Syndrome: A Population-Based Study Using the National Inpatient Sample"
540:
enzyme and acts by degrading uric acid. It is not recommended to alkalinize urine in the management of TLS.
606:
and hydration are the mainstays of treatment in patients with clinical evidence of tumor lysis syndrome. A
369:
111:
301:
158:
636:
313:
294:
1692:
1625:
567:
can also be used as options to remove potassium from the bloodstream when hyperkalemia is present.
559:) can also be used, but are temporary interventions, and potassium is not excreted from the body.
53:
547:
gastrointestinal tract using agents such as oral sodium polystyrene sulfonate, can be beneficial.
939:"Urate oxidase for the prevention and treatment of tumour lysis syndrome in children with cancer"
269:
75:
373:
107:
620:
552:
361:
341:
249:
365:
162:
103:
8:
1610:
1408:"Rasburicase represents a new tool for hyperuricemia in tumor lysis syndrome and in gout"
223:
138:
1464:
Tosi P, Barosi G, Lazzaro C, Liso V, Marchetti M, Morra E, et al. (December 2008).
1265:
Coiffier B, Riouffol C (February 2007). "Management of tumor lysis syndrome in adults".
1707:
1619:
1615:
1549:
1524:
1505:
1432:
1407:
1388:
1339:
1290:
1239:
1214:
1108:
963:
938:
914:
887:
814:
755:
730:
170:
91:
71:
1687:
1636:
1554:
1497:
1437:
1380:
1331:
1326:
1309:
1282:
1244:
1190:
1137:
1100:
1054:
1027:
994:
968:
919:
868:
806:
801:
784:
760:
682:
632:
628:
586:
227:
214:
166:
126:
38:
1540:
1392:
1343:
1294:
1185:
1168:
1112:
818:
431:
In 2004, Cairo and Bishop defined a classification system for tumor lysis syndrome.
1665:
1544:
1536:
1509:
1487:
1477:
1427:
1419:
1370:
1321:
1274:
1234:
1226:
1180:
1090:
958:
954:
950:
909:
899:
860:
796:
750:
742:
674:
529:
627:(in conjunction with glucose) and an agent to stabilize cardiac membranes such as
1630:
678:
321:
289:
394:, dehydration, and other issues affecting urinary flow or the acidity of urine.
1641:
1046:
564:
391:
154:
150:
1600:
1681:
1278:
1230:
864:
616:
607:
590:
537:
283:
192:
134:
130:
1558:
1501:
1482:
1465:
1441:
1384:
1335:
1286:
1248:
1194:
1104:
1058:
1031:
1015:
972:
923:
904:
872:
810:
764:
686:
612:
594:
582:
560:
402:
238:
183:
122:
115:
746:
603:
533:
525:
521:
517:
275:
254:
142:
1492:
1095:
1078:
989:
Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE (2014).
493:
Moreover, any symptomatic hypocalcemia should constitute clinical TLS.
419:
387:
332:
231:
146:
47:
1583:
1423:
1375:
1358:
1310:"Tumour lysis syndrome: new therapeutic strategies and classification"
1660:
556:
458:: laboratory tumor lysis syndrome plus one or more of the following:
337:
305:
219:
188:
418:
acid nephropathy is associated with little or no urine output. The
513:
509:
377:
99:
95:
83:
43:
888:"Tumor Lysis Syndrome in Patients with Hematological Malignancies"
988:
624:
548:
406:
243:
1466:"Consensus conference on the management of tumor lysis syndrome"
599:
Treatment is first targeted at the specific metabolic disorder.
551:
therapy (in conjunction with glucose administration) as well as
1595:
222:
are also predominantly intracellular. Hyperphosphatemia causes
121:
Tumor lysis syndrome is characterized by high blood potassium (
79:
1167:
Darmon M, Malak S, Guichard I, Schlemmer B (September 2008).
265:
sudden changes in mental status, including emotional lability
202:
87:
1166:
664:
461:
increased serum creatinine (1.5 times upper limit of normal)
1357:
Jones GL, Will A, Jackson GH, Webb NJ, Rule S (June 2015).
309:
1219:
1076:
380:) have also been associated with TLS but are less common.
782:
195:
137:), and higher than normal levels of blood urea nitrogen (
205:
conduction abnormalities, and arrhythmias (can be fatal)
90:) from the treatment, releasing their contents into the
850:
1405:
1463:
783:
Cairo MS, Coiffier B, Reiter A, Younes A (May 2010).
1573:
1356:
1169:"Acute tumor lysis syndrome: a comprehensive review"
1125:
1077:
Rampello E, Fricia T, Malaguarnera M (August 2006).
1016:"Potassium Disorders: Hypokalemia and Hyperkalemia"
993:(Fifth ed.). Philadelphia: Elsevier Saunders.
635:. Tumor lysis patients may ultimately also require
94:. This occurs most commonly after the treatment of
937:Cheuk DK, Chiang AK, Chan GC, Ha SY (March 2017).
885:
226:in tumor lysis syndrome, because of deposition of
936:
623:, while a temporizing agent such as rapid acting
405:, but TLS can be triggered in cancer patients by
1679:
1264:
1044:
728:
447:phosphate > 4.5 mg/dL or 25% increase
329:Pretreatment spontaneous tumor lysis syndrome
1522:
1399:
1301:
1070:
316:, are not features of tumor lysis syndrome.
1406:Cammalleri L, Malaguarnera M (March 2007).
1307:
1212:
943:The Cochrane Database of Systematic Reviews
658:
639:such as through hemodialysis if indicated.
441:uric acid > 8 mg/dL or 25% increase
1523:Durani U, Shah ND, Go RS (December 2017).
1126:Moossa AR, Schimpff SC, Robson MC (1991).
1053:, South Dartmouth (MA): MDText.com, Inc.,
426:
52:
1548:
1491:
1481:
1431:
1412:International Journal of Medical Sciences
1374:
1325:
1238:
1184:
1094:
1013:
962:
913:
903:
800:
754:
450:calcium < 7 mg/dL or 25% decrease
1208:
1206:
1204:
1079:"The management of tumor lysis syndrome"
729:Howard SC, Jones DP, Pui CH (May 2011).
1173:Revista Brasileira de Terapia Intensiva
1047:"Hypocalcemia: Diagnosis and Treatment"
615:without symptoms can be treated with a
14:
1680:
1213:Weeks AC, Kimple ME (26 August 2015).
444:potassium > 6 meq/L or 25% increase
1459:
1457:
1455:
1453:
1451:
1260:
1258:
1201:
886:Belay Y, Yirdaw K, Enawgaw B (2017).
724:
722:
720:
718:
716:
176:
984:
982:
846:
844:
842:
840:
838:
836:
834:
832:
830:
828:
778:
776:
774:
714:
712:
710:
708:
706:
704:
702:
700:
698:
696:
476:
242:. Because of the hyperphosphatemia,
1308:Cairo MS, Bishop M (October 2004).
1267:Expert Review of Anticancer Therapy
1014:Viera AJ, Wouk N (September 2015).
735:The New England Journal of Medicine
24:
1698:Conditions of the subcutaneous fat
1448:
1255:
1129:Comprehensive textbook of oncology
1083:Nature Clinical Practice. Oncology
464:cardiac arrhythmia or sudden death
25:
1719:
1569:
1134:Lippincott Williams & Wilkins
979:
930:
825:
771:
693:
1327:10.1111/j.1365-2141.2004.05094.x
802:10.1111/j.1365-2141.2010.08143.x
667:The American Journal of Medicine
102:and in particular when treating
1541:10.1634/theoncologist.2017-0147
1516:
1350:
1186:10.1590/S0103-507X2008000300011
1160:
1119:
436:Laboratory tumor lysis syndrome
376:(AML). Other cancers (such as
348:
1363:British Journal of Haematology
1314:British Journal of Haematology
1038:
1007:
955:10.1002/14651858.CD006945.pub4
879:
789:British Journal of Haematology
13:
1:
651:
496:
456:Clinical tumor lysis syndrome
398:Chemotherapy characteristics:
991:Aebeloff's Clinical Oncology
853:Journal of Clinical Oncology
679:10.1016/j.amjmed.2003.09.045
642:
576:
412:
370:acute lymphoblastic leukemia
208:muscle weakness or paralysis
112:acute lymphoblastic leukemia
7:
302:Acute uric acid nephropathy
159:acute uric acid nephropathy
10:
1724:
731:"The tumor lysis syndrome"
580:
141:). These changes in blood
1651:
1577:
1020:American Family Physician
637:renal replacement therapy
314:uric acid nephrolithiasis
295:monosodium urate crystals
133:), high blood uric acid (
125:), high blood phosphate (
82:, where large amounts of
37:
32:
1279:10.1586/14737140.7.2.233
1231:10.1177/2324709615603199
865:10.1200/JCO.2007.15.0177
384:Patient characteristics:
1703:Oncological emergencies
1225:(3): 2324709615603199.
427:Cairo-Bishop definition
230:crystals in the kidney
72:metabolic abnormalities
1483:10.3324/haematol.13290
553:beta-receptor agonists
374:acute myeloid leukemia
357:Tumor characteristics:
129:), low blood calcium (
108:acute myeloid leukemia
86:cells are killed off (
78:from the treatment of
747:10.1056/NEJMra0904569
621:polystyrene sulfonate
366:Non-Hodgkin Lymphomas
342:hematologic neoplasms
18:Tumour lysis syndrome
905:10.1155/2017/9684909
506:Acute kidney injury:
272:) movement disorders
163:acute kidney failure
104:non-Hodgkin lymphoma
74:that can occur as a
64:Tumor lysis syndrome
33:Tumor lysis syndrome
892:Journal of Oncology
338:cytotoxic treatment
224:acute kidney injury
171:cardiac arrhythmias
1652:External resources
1096:10.1038/ncponc0581
362:Burkitt's lymphoma
218:. Like potassium,
177:Signs and symptoms
1675:
1674:
1535:(12): 1506–1509.
1476:(12): 1877–1885.
1424:10.7150/ijms.4.83
1376:10.1111/bjh.13403
1000:978-1-4557-2865-7
859:(16): 2767–2778.
741:(19): 1844–1854.
633:calcium gluconate
629:calcium carbonate
587:hyperphosphatemia
477:Howard definition
228:calcium phosphate
215:Hyperphosphatemia
127:hyperphosphatemia
61:
60:
27:Medical condition
16:(Redirected from
1715:
1575:
1574:
1563:
1562:
1552:
1520:
1514:
1513:
1495:
1485:
1461:
1446:
1445:
1435:
1403:
1397:
1396:
1378:
1354:
1348:
1347:
1329:
1305:
1299:
1298:
1262:
1253:
1252:
1242:
1210:
1199:
1198:
1188:
1164:
1158:
1157:
1152:
1150:
1123:
1117:
1116:
1098:
1074:
1068:
1067:
1066:
1065:
1042:
1036:
1035:
1011:
1005:
1004:
986:
977:
976:
966:
934:
928:
927:
917:
907:
883:
877:
876:
848:
823:
822:
804:
780:
769:
768:
758:
726:
691:
690:
662:
530:xanthine oxidase
70:) is a group of
57:
56:
30:
29:
21:
1723:
1722:
1718:
1717:
1716:
1714:
1713:
1712:
1693:Blood disorders
1678:
1677:
1676:
1671:
1670:
1647:
1646:
1586:
1572:
1567:
1566:
1521:
1517:
1462:
1449:
1404:
1400:
1355:
1351:
1306:
1302:
1263:
1256:
1211:
1202:
1165:
1161:
1148:
1146:
1144:
1132:. Vol. 2.
1124:
1120:
1075:
1071:
1063:
1061:
1043:
1039:
1012:
1008:
1001:
987:
980:
949:(3): CD006945.
935:
931:
884:
880:
849:
826:
781:
772:
727:
694:
663:
659:
654:
645:
597:
581:Main articles:
579:
536:is a synthetic
499:
479:
429:
415:
351:
322:Lactic acidosis
290:hyperuricosuria
262:muscle weakness
179:
51:
28:
23:
22:
15:
12:
11:
5:
1721:
1711:
1710:
1705:
1700:
1695:
1690:
1673:
1672:
1669:
1668:
1656:
1655:
1653:
1649:
1648:
1645:
1644:
1633:
1622:
1603:
1587:
1582:
1581:
1579:
1578:Classification
1571:
1570:External links
1568:
1565:
1564:
1529:The Oncologist
1515:
1447:
1398:
1369:(5): 661–671.
1349:
1300:
1273:(2): 233–239.
1254:
1200:
1179:(3): 278–285.
1159:
1142:
1118:
1089:(8): 438–447.
1069:
1037:
1026:(6): 487–495.
1006:
999:
978:
929:
878:
824:
795:(4): 578–586.
770:
692:
673:(8): 546–554.
656:
655:
653:
650:
644:
641:
578:
575:
565:hemofiltration
498:
495:
491:
490:
487:
478:
475:
471:
470:
469:
468:
465:
462:
453:
452:
451:
448:
445:
442:
428:
425:
414:
411:
392:kidney failure
350:
347:
346:
345:
326:
299:
298:
280:
279:
278:
273:
270:extrapyramidal
268:Parkinsonian (
266:
263:
260:
257:
252:
235:
211:
210:
209:
206:
201:palpitations,
178:
175:
151:rhabdomyolysis
59:
58:
41:
35:
34:
26:
9:
6:
4:
3:
2:
1720:
1709:
1706:
1704:
1701:
1699:
1696:
1694:
1691:
1689:
1686:
1685:
1683:
1667:
1663:
1662:
1658:
1657:
1654:
1650:
1643:
1639:
1638:
1634:
1632:
1628:
1627:
1623:
1621:
1617:
1613:
1612:
1608:
1604:
1602:
1598:
1597:
1593:
1589:
1588:
1585:
1580:
1576:
1560:
1556:
1551:
1546:
1542:
1538:
1534:
1530:
1526:
1519:
1511:
1507:
1503:
1499:
1494:
1489:
1484:
1479:
1475:
1471:
1470:Haematologica
1467:
1460:
1458:
1456:
1454:
1452:
1443:
1439:
1434:
1429:
1425:
1421:
1417:
1413:
1409:
1402:
1394:
1390:
1386:
1382:
1377:
1372:
1368:
1364:
1360:
1353:
1345:
1341:
1337:
1333:
1328:
1323:
1319:
1315:
1311:
1304:
1296:
1292:
1288:
1284:
1280:
1276:
1272:
1268:
1261:
1259:
1250:
1246:
1241:
1236:
1232:
1228:
1224:
1220:
1216:
1209:
1207:
1205:
1196:
1192:
1187:
1182:
1178:
1174:
1170:
1163:
1156:
1145:
1143:9780683061475
1139:
1135:
1131:
1130:
1122:
1114:
1110:
1106:
1102:
1097:
1092:
1088:
1084:
1080:
1073:
1060:
1056:
1052:
1048:
1041:
1033:
1029:
1025:
1021:
1017:
1010:
1002:
996:
992:
985:
983:
974:
970:
965:
960:
956:
952:
948:
944:
940:
933:
925:
921:
916:
911:
906:
901:
897:
893:
889:
882:
874:
870:
866:
862:
858:
854:
847:
845:
843:
841:
839:
837:
835:
833:
831:
829:
820:
816:
812:
808:
803:
798:
794:
790:
786:
779:
777:
775:
766:
762:
757:
752:
748:
744:
740:
736:
732:
725:
723:
721:
719:
717:
715:
713:
711:
709:
707:
705:
703:
701:
699:
697:
688:
684:
680:
676:
672:
668:
661:
657:
649:
640:
638:
634:
630:
626:
622:
618:
617:loop diuretic
614:
609:
608:loop diuretic
605:
600:
596:
592:
591:hyperuricemia
588:
584:
574:
572:
571:Hypocalcemia:
568:
566:
562:
558:
554:
550:
545:
544:Hyperkalemia:
541:
539:
538:urate oxidase
535:
531:
527:
523:
519:
515:
511:
507:
503:
494:
488:
484:
483:
482:
474:
466:
463:
460:
459:
457:
454:
449:
446:
443:
440:
439:
437:
434:
433:
432:
424:
421:
410:
408:
404:
399:
395:
393:
389:
385:
381:
379:
375:
371:
367:
363:
358:
354:
343:
339:
334:
330:
327:
324:
323:
319:
318:
317:
315:
311:
307:
303:
296:
292:
291:
286:
285:
284:Hyperuricemia
281:
277:
274:
271:
267:
264:
261:
259:muscle cramps
258:
256:
253:
251:
248:
247:
245:
241:
240:
236:
233:
229:
225:
221:
217:
216:
212:
207:
204:
200:
199:
197:
194:
193:intracellular
191:is mainly an
190:
186:
185:
181:
180:
174:
173:, and death.
172:
168:
164:
160:
156:
152:
148:
144:
140:
136:
135:hyperuricemia
132:
128:
124:
119:
117:
113:
109:
105:
101:
97:
93:
89:
85:
81:
77:
73:
69:
65:
55:
49:
45:
42:
40:
36:
31:
19:
1659:
1635:
1624:
1605:
1590:
1532:
1528:
1518:
1473:
1469:
1418:(2): 83–93.
1415:
1411:
1401:
1366:
1362:
1352:
1317:
1313:
1303:
1270:
1266:
1222:
1218:
1176:
1172:
1162:
1154:
1147:. Retrieved
1128:
1121:
1086:
1082:
1072:
1062:, retrieved
1050:
1040:
1023:
1019:
1009:
990:
946:
942:
932:
895:
891:
881:
856:
852:
792:
788:
738:
734:
670:
666:
660:
646:
613:hyperkalemia
602:In general,
601:
598:
595:hypocalcemia
583:hyperkalemia
570:
569:
561:Hemodialysis
543:
542:
505:
504:
500:
492:
480:
472:
455:
435:
430:
416:
403:chemotherapy
397:
396:
383:
382:
356:
355:
352:
349:Risk factors
328:
320:
300:
288:
282:
255:paresthesias
239:Hypocalcemia
237:
213:
184:Hyperkalemia
182:
143:electrolytes
131:hypocalcemia
123:hyperkalemia
120:
116:chemotherapy
76:complication
67:
63:
62:
1493:11585/72920
1320:(1): 3–11.
898:: 9684909.
619:and sodium
604:rasburicase
534:Rasburicase
526:Allopurinol
522:rasburicase
518:allopurinol
372:(ALL), and
276:papilledema
147:metabolites
92:bloodstream
1682:Categories
1637:DiseasesDB
1064:2022-03-11
652:References
497:Prevention
420:urinalysis
388:creatinine
333:nucleobase
232:parenchyma
220:phosphates
48:hematology
1708:Syndromes
1661:eMedicine
643:Prognosis
577:Treatment
557:albuterol
555:(such as
514:leukemias
510:lymphomas
413:Diagnosis
364:), other
306:uric acid
189:Potassium
155:cytotoxic
100:leukemias
96:lymphomas
39:Specialty
1688:Oncology
1666:med/2327
1559:28904174
1502:18838473
1442:17396159
1393:46803727
1385:25876990
1344:35738745
1336:15384972
1295:41115749
1287:17288532
1249:26904699
1195:25307096
1113:23245352
1105:16894389
1059:25905251
1051:Endotext
1032:26371733
973:28272834
924:29230244
873:18509186
819:29473031
811:20331465
765:21561350
687:15063817
486:sepsis).
378:melanoma
167:seizures
44:Oncology
1631:D015275
1550:5728022
1510:7146760
1433:1838823
1240:4748506
964:6464610
915:5688348
756:3437249
625:insulin
549:Insulin
467:seizure
407:steroid
368:(NHL),
244:calcium
203:cardiac
1620:995.29
1616:277.88
1557:
1547:
1508:
1500:
1440:
1430:
1391:
1383:
1342:
1334:
1293:
1285:
1247:
1237:
1193:
1140:
1111:
1103:
1057:
1030:
997:
971:
961:
922:
912:
871:
817:
809:
763:
753:
685:
593:, and
250:tetany
110:, and
80:cancer
50:
1642:32051
1601:E88.3
1506:S2CID
1389:S2CID
1340:S2CID
1291:S2CID
1149:2 May
1109:S2CID
815:S2CID
88:lysed
84:tumor
1626:MeSH
1611:9-CM
1555:PMID
1498:PMID
1438:PMID
1381:PMID
1332:PMID
1283:PMID
1245:PMID
1191:PMID
1151:2012
1138:ISBN
1101:PMID
1055:PMID
1028:PMID
995:ISBN
969:PMID
947:2017
920:PMID
896:2017
869:PMID
807:PMID
761:PMID
683:PMID
563:and
512:and
312:and
310:gout
287:and
145:and
98:and
1607:ICD
1592:ICD
1545:PMC
1537:doi
1488:hdl
1478:doi
1428:PMC
1420:doi
1371:doi
1367:169
1322:doi
1318:127
1275:doi
1235:PMC
1227:doi
1181:doi
1091:doi
959:PMC
951:doi
910:PMC
900:doi
861:doi
797:doi
793:149
751:PMC
743:doi
739:364
675:doi
671:116
528:(a
520:or
340:of
196:ion
139:BUN
68:TLS
1684::
1664::
1640::
1629::
1618:,
1614::
1599::
1596:10
1553:.
1543:.
1533:22
1531:.
1527:.
1504:.
1496:.
1486:.
1474:93
1472:.
1468:.
1450:^
1436:.
1426:.
1414:.
1410:.
1387:.
1379:.
1365:.
1361:.
1338:.
1330:.
1316:.
1312:.
1289:.
1281:.
1269:.
1257:^
1243:.
1233:.
1221:.
1217:.
1203:^
1189:.
1177:20
1175:.
1171:.
1153:.
1136:.
1107:.
1099:.
1085:.
1081:.
1049:,
1024:92
1022:.
1018:.
981:^
967:.
957:.
945:.
941:.
918:.
908:.
894:.
890:.
867:.
857:26
855:.
827:^
813:.
805:.
791:.
787:.
773:^
759:.
749:.
737:.
733:.
695:^
681:.
669:.
589:,
585:,
524:.
390:,
308:,
187:.
169:,
165:,
161:,
106:,
46:,
1609:-
1594:-
1584:D
1561:.
1539::
1512:.
1490::
1480::
1444:.
1422::
1416:4
1395:.
1373::
1346:.
1324::
1297:.
1277::
1271:7
1251:.
1229::
1223:3
1197:.
1183::
1115:.
1093::
1087:3
1034:.
1003:.
975:.
953::
926:.
902::
875:.
863::
821:.
799::
767:.
745::
689:.
677::
344:.
325:.
297:.
234:.
66:(
20:)
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
