Clin Mol Hepatol.  2015 Mar;21(1):85-88. 10.3350/cmh.2015.21.1.85.

Low-dose steroid-induced tumor lysis syndrome in a hepatocellular carcinoma patient

• Kim JO
• Jun DW
• Tae HJ
• Lee KN
• Lee HL
• Lee OY
• Choi HS
• Yoon BC
• Hahm JS

• KMID: 2155295
• DOI: http://doi.org/10.3350/cmh.2015.21.1.85

Abstract

Tumor lysis syndrome is rare in hepatocellular carcinoma (HCC), but it has been reported more frequently recently in response to treatments such as transcatheter arterial chemoembolization (TACE), radiofrequency thermal ablation (RFTA), and sorafenib. Tumor lysis syndrome induced by low-dose steroid appears to be very unusual in HCC. We report a patient with hepatitis-C-related liver cirrhosis and HCC in whom tumor lysis syndrome occurred due to low-dose steroid (10 mg of prednisolone). The patient was a 90-year-old male who presented at the emergency room of our hospital with general weakness and poor oral intake. He had started to take prednisolone to treat adrenal insufficiency 2 days previously. Laboratory results revealed hyperuricemia, hyperphosphatemia, and increased creatinine. These abnormalities fulfilled the criteria in the Cairo-Bishop definition of tumor lysis syndrome. Although the patient received adequate hydration, severe metabolic acidosis and acute kidney injury progressed unabated. He finally developed multiple organ failure, and died 3 days after admission. This was a case of tumor lysis syndrome caused by administration of low-dose steroid in a patient with HCC.

Keyword

Tumor lysis syndrome; Hepatocellular carcinoma; Steroid

MeSH Terms

Acute Kidney Injury/pathology
Aged, 80 and over
Antineoplastic Agents/therapeutic use
Carcinoma, Hepatocellular/*pathology/therapy
Chemoembolization, Therapeutic
Creatinine/blood
Humans
Liver Neoplasms/*pathology/*therapy
Male
Niacinamide/analogs & derivatives/therapeutic use
Phenylurea Compounds/therapeutic use
Steroids/adverse effects/therapeutic use
Tomography, X-Ray Computed
Tumor Lysis Syndrome/*diagnosis/drug therapy
Antineoplastic Agents
Creatinine
Niacinamide
Phenylurea Compounds
Steroids