Tumor lysis syndrome laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]

Overview

Laboratory findings consistent with the diagnosis of tumor lysis syndrome include high serum uric acid, potassium, phosphorus, and low calcium.[1]

Laboratory Findings

Laboratory findings consistent with the diagnosis of tumor lysis syndrome include:[1]

  • Blood:
  • Urinalysis:
  • Low urine output
  • Uric acid crystals or amorphous urates
  • High uric acid-Creatinine ratio > 1.0

Cairo-Bishop Definition

  • Laboratory tumor lysis syndrome: abnormalitiy in two or more of the following and occurs within 3 days before or 7 days after chemotherapy.
    • uric acid > 8 mg/dL or 25% increase
    • potassium > 6 meq/L or 25% increase
    • phosphate > 4.5 mg/dL or 25% increase
    • calcium < 7 mg/dL or 25% decrease
  • Clinical tumor lysis syndrome: laboratory tumor lysis syndrome plus one or more of the following:
    • increase serum creatinine (1.5 times upper limit of normal)
    • cardiac arrhythmia or sudden death
    • seizure

A grading scale (0-5) is used depending on the presence of lab TLS, serum creatinine, arrhythmias, or seizures.

References

  1. 1.0 1.1 Cairo MS, Bishop M (2004). "Tumour lysis syndrome: new therapeutic strategies and classification". Br J Haematol. 127 (1): 3–11. doi:10.1111/j.1365-2141.2004.05094.x. PMID 15384972.

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