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Pediatric_Oncology_A_Comprehensive_Guide.pdf
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192

 

 

T. Kühne

 

 

 

 

 

18.9.2

Diagnosis....................................................................................................

199

 

18.9.3

Treatment ...................................................................................................

199

18.10

Hemolysis ..................................................................................................................

199

 

18.10.1

General.......................................................................................................

199

 

18.10.2

Diagnosis....................................................................................................

199

 

18.10.3

Treatment ...................................................................................................

200

18.11 Abdominal Emergencies and Abdominal Tumor.......................................................

200

 

18.11.1

General.......................................................................................................

200

 

18.11.2

Diagnosis....................................................................................................

200

 

18.11.3

Treatment ...................................................................................................

200

18.12

Hemorrhagic Cystitis, Dysuria...................................................................................

201

 

18.12.1

General.......................................................................................................

201

 

18.12.2

Diagnosis....................................................................................................

201

 

18.12.3

Treatment ...................................................................................................

201

18.13 Acute Alteration of Consciousness............................................................................

201

 

18.13.1

General.......................................................................................................

201

 

18.13.2

Diagnosis....................................................................................................

201

 

18.13.3

Treatment ...................................................................................................

202

18.14

Seizures

....................................................................................................................

202

 

18.14.1

General.......................................................................................................

202

 

18.14.2

Diagnosis....................................................................................................

202

 

18.14.3

Treatment ...................................................................................................

202

18.1Tumor Lysis and Hyperleukocytosis

18.1.1 General

Spontaneous or chemotherapeutic drug-induced cell lysis causes hyperkalemia, uric acid elevation, hyperphosphatemia, and hypokalemia, and occurs in tumors with high proliferation rate, for example, Burkitt lymphoma, T-cell acute lymphoblastic leukemia (ALL), and non-Hodgkin’s lymphoma (NHL), less frequently precursor B-cell ALL, acute myelogenous leukemia (AML), and neuroblastoma stage IVS

Hyperleukocytosis: leukocytes usually >100 × 109/l

18.1.2 Diagnosis

Symptoms of tumor lysis caused by hyperkalemia; may be accompanied by hypocalcemia (Chvostek and Trousseau signs, convulsions, symptoms of renal insufficiency)

Laboratory analysis: blood gas analysis, complete blood count (CBC), blood smear and leukocyte differentiation, sodium, potassium, calcium, magnesium, urea, creatinine, phosphorus, lactate dehydrogenase (LDH), and uric acid. Other diagnostic investigations according to suspected diagnosis

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