Daño renal agudo debido a un síndrome de lisis tumoral espontáneo como primera manifestación del linfoma de Burkitt
- M.J. Sánchez Soler
- M. Alcaraz Saura
- A. García Lax
- C. Vicente Calderón
- J. L. Fuster Soler
ISSN: 0001-6640
Year of publication: 2016
Volume: 74
Issue: 11
Pages: 251-253
Type: Article
More publications in: Acta pediátrica española
Abstract
Spontaneous tumour lysis syndrome (STLS) is an extraordinary cause of acute kidney injury (AKI). We report a case of AKI caused by STLS as first sign of Burkitt lymphoma. Five-year-old boy with one month history of anorexia, elevated levels in blood (mg/dL) of urea/creatinine (337/7.21), uric acid (30.4), phosphorous (7); potassium 6.6 mEq/L, and large echogenic kidneys in abdominal ultrasound. Progressive improvement in kidney function was evident after starting rasburicase and hyperhydratation therapy. On day +14, abdominal ultrasound was performed because of clinical deterioration and it showed a big retroperitoneal mass, which was biopsied. During the procedure, after dexamethasone administrations (intubation protocol), he suffered ventricular tachycardia, reverted without cardioversion. 48 hours haemodiafiltration was needed. The biopsy showed Burkitt lymphoma, specific treatment was started and the boy is nowadays in remission. In the case of AKI with hyperphosporemia, hyperkaliemia and hyperuricemia suspecting STLS is mandatory and avoid steroid therapy as it could be live threatening.