A rare case of tumour lysis syndrome in multiple myeloma

Abstract

Tumour lysis syndrome (TLS) is a serious life-threatening complication of cancer chemotherapy which is a constellation of metabolic disturbances that typically occurs during therapy of bulky, rapidly proliferative tumours. TLS is an oncological emergency that causes a significant release of phosphate, potassium, uric acid, and nucleic acids into the blood stream. Incidence of TLS in multiple myeloma is rare. Here we present a case of multiple myeloma who later developed tumour lysis syndrome in its due course which was rare. A 67-year-old male was diagnosed with Multiple myeloma on the basis of M spike, osteolytic lesions and bone marrow analysis. First cycle of chemotherapy with lenalidomide, bortezomib and denosumab was initiated. During the course of follow up he presented to our casualty with complaints of chills and rigor. Based on the biochemical abnormalities a diagnosis of tumour lysis syndrome was made. He received I.V fluids, anti-hyperkalemic measures, allopurinol. He had neutropenic sepsis and went into septic shock and died after multiple resuscitative efforts.