A case report of severe hypo-phosphatemia due to paraneoplastic syndrome followed by severe hyper-phosphatemia due to tumor lysis syndrome after CHOP chemotherapy

• Published in: Gan to kagaku ryoho Vol. 39; no. 2; p. 325
• Main Authors: Ito, Tadaaki, Uchida, Yumiko, Takagi, Shinsuke, Uchida, Naoyuki, Taniguchi, Shuichi, Hayashi, Masahiro
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.02.2012
• Subjects: Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cyclophosphamide - adverse effects; Cyclophosphamide - therapeutic use; Doxorubicin - adverse effects; Doxorubicin - therapeutic use; Humans; Lymphoma, B-Cell - drug therapy; Male; Middle Aged; Paraneoplastic Syndromes - blood; Phosphates - blood; Prednisone - adverse effects; Prednisone - therapeutic use; Tumor Lysis Syndrome - blood; Vincristine - adverse effects; Vincristine - therapeutic use
• ISSN: 0385-0684

A 51-year-old man who underwent umbilical cord blood transplantation for acute lymphoblastic leukemia with a Philadelphia chromosome in April 2006 achieved complete remission. In June 2008, progressive renal dysfunction and melena emerged and the patient was diagnosed with B-cell-type malignant lymphoma. He presented with severe hypo-phosphate- mia(0. 1m g/dL)due to paraneoplastic syndrome, simultaneously. Because the development of tumor lysis syndrome followed by hyper-phophatemia was feared to occur after CHOP chemotherapy, we discontinued the adjustment of serum phosphorus. The serum phosphorus level was elevated to 11.6mg/dL after 3 days and decreased to 3. 8mg/dL after 5 days. We must be careful regarding hyper-phosphatemia and phosphorus adjustment even in patients with severe hypo-phosphatemia that is due to paraneoplastic syndrome.