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UNIVERSIDADE FEDERAL DO PIAUÍ - UFPICENTRO DE CIÊNCIA DA SAÚDE - CCSDEPARTAMENTO DE CLÍNICA GERALPROFESSOR: Dr. SABAS CARLOS VIEIRAALUNO: NEMÉSIO GARCIA DO N. FILHO
T HE NEW ENGLAND JOURNAL OF MEDICINEREVIEW ARTICLE
The Tumor Lysis SyndromeFrom the Department of Oncology and International Outreach Program, St. JudeChildren’s Research Hospital (S.C.H.,C.-H.P.), and the Department of Pediatrics,University of Tennessee Health Sciences Center, College of Medicine (S.C.H., D.P.J.,C.-H.P.) — both in Memphis.
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Tumor Lysis SyndromeCONCEITO:É uma alteração metabólica decorrente de
destruição celular em massa, geralmente associada a início de tratamento cititóxico.
É uma Emergência oncológica.
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FREQUÊNCIAPacientes com: linfoma não-Hodgkin leucemia aguda
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Quando ocorre?
Células tumorais liberam seus conteúdo na corrente sanguínea.
Achados característicos:
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TRÍADE CLÁSSICA
HiperuricemiaHipercalemiaHiperfosfatemia hipercalcemia
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Classificação atual do Cairo e Bishop:
Biológica
Clínica
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Pathophysiology
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EpidemiologyIncidência e gravidade da SLT depende:Massa do câncerPotencial de lise celularCaracterística do ptc.Cuidados de suporte
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SÍNDROME DE LISE TUMORAL
Caimbras musculares e tetania Sinais e sintomas OligoanúriaArritimias cardíacas
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SLT - FATORES PREDISPONENTES
Massa tumoral grande
Organomegalia importante
Hiperleucocitose
ácido úrico e DHL pré-tratamento
Baixo débito urinário
Acidose
Quimiossensibilidade do tumor
Depleção de volume
Urina ácida
Disfunção renal pré-existente
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References
1. Abu-Alfa AK, Younes A. Tumor lysis syndrome and acute kidney injury: evaluation, prevention, and management. Am J Kidney Dis
2. Cairo MS, Coiffier B, Reiter A, Younes A. 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. Br J Haematol 2010;149:578-86.
3. Gertz MA. Managing tumor lysis syndrome in 2010. Leuk Lymphoma 2010;51: 179-80.
4. Magrath IT, Semawere C, Nkwocha J.Causes of death in patients with Burkitt’s lymphoma — the role of supportive care in overall management. East Afr Med J 1974;51:623-32.
5. Krishnan G, D’Silva K, Al-Janadi A. Cetuximab-related tumor lysis syndrome in metastatic colon carcinoma. J Clin Oncol 2008;26:2406-8.