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Old 10-24-2011
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Question Hyperphosphatemia in Tumor Lysis Syndrome

Hi all:

In tumor lysis syndrome, do we have hyperphosphotemia or hypophosphotemia? In Kaplan CK Notes, it says we have hypophosphotemia (Kaplan Pediatrics p.216 2008~2009 version). But i think we have hyperphosphotemia because we release phosphate from our cells, right?
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Old 10-24-2011
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Hyperphosphatemia. Like potassium, phosphates are also predominantly intracellular. Hyperphosphatemia causes acute renal failure in tumor lysis syndrome, because of deposition of calcium phosphate crystals in the renal parenchyma.
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Old 10-24-2011
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i am sure its hyperphosphatemia,,,we have increased potassium, phosphate and uric acid...this is acc to step 1 uworld...
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Old 10-25-2011
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while sitting in prometric and exam missed due to ECFMG having server issues.


Just a thought the hyperphosphatemia is the initial state later on the high PO4 then interacts with the Ca released forming calcium phosphtate which causes a HYPOCalcemia and HYPOPhosphatemia
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Old 10-25-2011
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hyperphosphatemia in uworld step 2! too
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Old 10-25-2011
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Since i cant really study, i searched and found this in a pediatric article regarding hyperphosphatemia in tumor lysis syndrome.

Hyperphosphatemia results from the rapid release of intracellular phosphorus. Of note, malignant cells contain about four times as much phosphorus as a normal cell. As phosphate levels increase, they begin to combine with calcium, precipitating in the renal tubules (leading to kidney stones and failure) and the soft tissues (including muscle). This leads to a rapid drop in blood calcium levels, which may clinically present as agitation, tetany, severe muscle cramping and twitching, laryngospasm, and cardiac arrhythmias.

So yeah even though it does ppt with the calcium its lvls are still so much higher it still in the hyperphosphatemia range.
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Electrolytes-, Hematology-, Oncology-

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