Lab findings of Tumor lysis syndrome
What laboratory findings are associated with Tumor lysis syndrome?
Laboratory analysis in Tumor lysis syndrome typically reveals hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia, and elevated LDH levels. In TLS, the uric acid and LDH levels are often quite elevated.
Malignant cells can be very metabolically active, with large amounts of adenosine triphosphate, and can contain up to four times the amount of phosphorus found in normal cells.
If AKI develops, decreased kidney clearance of phosphorus and potassium can worsen the hyperphosphatemia and hyperkalemia. Hypocalcemia develops in tumor lysis when calcium complexes with phosphorus.
Hyperuricemia develops in TLS as purine nucleic acids are released from cells that are often rich in nucleic acid material due to their high turnover rates. Purines are sequentially metabolized into hypoxanthine, then xanthine, and finally uric acid.
The intracellular enzyme LDH is often increased in TLS. The pretreatment LDH level is a risk factor for developing TLS because it is a marker of increased tumor burden.
