Proximal tubular dysfunction associated with Burkitt's lymphoma

Goldsweig, Howard; Champlain, Marie-Laure Brisson De; Davidman, Michael

doi:10.1002/1097-0142(197802)41:2<568::aid-cncr2820410225>3.0.co;2-c

Cited by 9 publications

(1 citation statement)

References 60 publications

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“…A few reports describe hypophosphatemia associated with Fanconi syndrome in patients with acute or relapsed adult T cell leukemia/lymphoma and Burkitt lymphoma. The etiology is attributed to infiltration of renal parenchyma by lymphomatous cells and a speculated role of human T lymphotropic virus 1, causing direct proximal tubule dysfunction [ 97 , 98 ]. In patients with monoclonal gammopathy, the accumulation of light chains, mainly kappa light chains, in the proximal tubules can alter the cells’ proteolytic function, forming an intracellular crystal, or, through oxidative stress, can lead to cell dedifferentiation of the cells, apoptosis and subsequent loss of reabsorptive capacity [ 99 , 100 ].…”

Section: Etiology Of Hypophosphatemia In Cancermentioning

confidence: 99%

Hypophosphatemia in cancer patients

Adhikari

Mamlouk

Rondon‐Berrios

et al. 2021

Clinical Kidney Journal

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Dysregulation of phosphorus homeostasis resulting in hypophosphatemia is common in cancer patients and can result in serious complications and impact outcomes. Several factors, including critical illness, nutritional status, cancer type, and therapy, influence the development of hypophosphatemia. Hypophosphatemia can develop as a result of phosphaturic mesenchymal tumors or as a paraneoplastic phenomenon. The clinical presentation for hypophosphatemia varies depending on the duration and severity of the hypophosphatemia and affects several organ systems. Among other serious effects, hypophosphatemia can impair tissue oxygenation, cause hemolysis, leukocyte and platelet dysfunction, encephalopathy, seizures, arrhythmias, cardiomyopathy, rhabdomyolysis, and coma. Multiple studies have demonstrated that hypophosphatemia is an adverse prognostic marker in inpatients with increased in-hospital stay, mortality, and postoperative complications. The phosphate level is homeostatically regulated and maintained in a narrow range by 3 main hormones: PTH, FGF-23, and 1,25 (OH)2 Vitamin D3. Together, these hormones regulate how the intestine, kidneys, and bones traffic phosphorus. Several hematological malignancies and cancer therapies are associated with proximal tubular dysfunction (Fanconi syndrome), resulting in phosphaturia. Caution should be taken with parenteral administration of phosphate salts because secondary complications can develop principally due to hypocalcemia. The general approach to hypophosphatemia should target the underlying cause. Early recognition and prevention are essential, and the approach to hypophosphatemia in the cancer patient because of the nuances and complexity should be multidisciplinary.

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Section: Etiology Of Hypophosphatemia In Cancermentioning

confidence: 99%

Hypophosphatemia in cancer patients

Adhikari

Mamlouk

Rondon‐Berrios

et al. 2021

Clinical Kidney Journal

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Urinary cytodiagnostic abnormalities in 50 patients with non-Hodgkin's lymphomas

Cheson

Schumann

1984

Cancer

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Urinary cytodiagnostic evaluation was performed on 50 consecutive patients with non‐Hodgkin's lymphomas. In 14 patients (28%) the urine sediment contained characteristic lymphoma cells. The groups with or without a positive urine cytology were comparable with respect to type of lymphoma, stage and course of disease, and recent treatment with chemotherapy. However, those with a positive urine cytology were more likely to have clinical evidence of kidney disease (43% vs 8%), although this was rarely attributed to disseminated lymphoma. In fact, in three patients, a positive urine cytology was the sole or presenting evidence for disseminated lymphoma. Although the groups with or without a positive cytology were similar with regard to physicochemical urinary findings, there were marked differences in the frequency of microscopic abnormalities. All patients with a positive cytology had evidence of renal parenchymal necrosis, renal tubular injury, or pathologic cast formation as compared with only 56% of those with a negative cytology. Thus, urinary cytodiagnostic evaluation may provide an important adjunct in the staging and evaluation of patients with malignant lymphomas.

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