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A Tumor Lysis-Like Syndrome during Therapy of Visceral Leishmaniasis

Address correspondence to Moses Elisaf, M.D., Department of Internal Medicine, University of Ioannina, 451 10 Ioannina, Greece; tel 30 651 097509; fax 30 651 097016; e-mail egepi{at}cc.uoi.gr.

Abstract

Reported herein for the first time in the literature is the case of a 41-yr-old woman who developed a tumor lysis-like syndrome, consisting of hyperkalemia, hyperphosphatemia, hyperuricemia, and acute renal insufficiency, soon after the initiation of chemotherapy for severe visceral leishmaniasis with liposomal amphotericin B. Allopurinol therapy, together with iv fluid administration and urine alkalization, resulted in full recovery of the metabolic abnormalities. Awareness of this condition can lead to prophylactic treatment as well as the early recognition and management of susceptible patients.

Keywords: tumor lysis syndrome, leishmaniasis, hyperphosphatemia, hyperkalemia, hyperuricemia