A Case Report of Atezolizumab Induced Tumor Lysis Syndrome

BACKGROUND Advanced urothelial carcinoma has been associated with poor prognosis due to high resistance to chemotherapy and radiation until immunotherapeutic agents, such as atezolizumab, emerged as an option and have shown improved survival. However, atezolizumab is associated with side effects, wh...

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Bibliographic Details
Published inThe American journal of case reports Vol. 20; pp. 785 - 789
Main Authors Fa'ak, Faisal, Vanegas, Diego, Osei, Kofi M
Format Journal Article
LanguageEnglish
Published United States International Scientific Literature, Inc 04.06.2019
Subjects
Aged
Antibodies, Monoclonal, Humanized - administration & dosage
Antibodies, Monoclonal, Humanized - adverse effects
Biopsy, Needle
Carcinoma, Transitional Cell - diagnostic imaging
Carcinoma, Transitional Cell - drug therapy
Carcinoma, Transitional Cell - pathology
Disease Progression
Emergency Service, Hospital
Female
Hospice Care
Humans
Immunohistochemistry
Monitoring, Physiologic
Neoplasm Invasiveness - pathology
Neoplasm Staging
Tomography, X-Ray Computed - methods
Tumor Lysis Syndrome - etiology
Tumor Lysis Syndrome - physiopathology
Urinary Bladder Neoplasms - diagnostic imaging
Urinary Bladder Neoplasms - drug therapy
Urinary Bladder Neoplasms - pathology
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Summary:BACKGROUND Advanced urothelial carcinoma has been associated with poor prognosis due to high resistance to chemotherapy and radiation until immunotherapeutic agents, such as atezolizumab, emerged as an option and have shown improved survival. However, atezolizumab is associated with side effects, which were mainly autoimmune. In this case study, we report on a rare case of atezolizumab-induced tumor lysis syndrome. CASE REPORT A 67-year-old female with a primary diagnosis of metastatic urothelial carcinoma who presented to the emergency department with generalized weakness associated with nausea and vomiting 8 days after her first cycle of atezolizumab. Laboratory values showed hyperphosphatemia, hyperuricemia, hypocalcemia, and acute kidney injury consistent with tumor lysis syndrome. CONCLUSIONS In our report, we highlight tumor lysis syndrome as a potential reaction to atezolizumab; a condition that requires prophylaxis and close laboratory monitoring.
Bibliography:Funds Collection
Authors’ Contribution
Conflict of interest: None declared
Data Interpretation
Literature Search
Data Collection
Study Design
Manuscript Preparation
Statistical Analysis
ISSN:1941-5923
1941-5923
DOI:10.12659/AJCR.915351