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Gri N, Longhitano Y, Zanza C, Monticone V, Fuschi D, Piccioni A, Bellou A, Esposito C, Ceresa IF, Savioli G. Acute Oncologic Complications: Clinical-Therapeutic Management in Critical Care and Emergency Departments. Curr Oncol 2023; 30:7315-7334. [PMID: 37623012 PMCID: PMC10453099 DOI: 10.3390/curroncol30080531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/01/2023] [Accepted: 07/10/2023] [Indexed: 08/26/2023] Open
Abstract
Introduction. It is now known that cancer is a major public health problem; on the other hand, it is less known, or rather, often underestimated, that a significant percentage of cancer patients will experience a cancer-related emergency. These conditions, depending on the severity, may require treatment in intensive care or in the emergency departments. In addition, it is not uncommon for a tumor pathology to manifest itself directly, in the first instance, with a related emergency. The emergency unit proves to be a fundamental and central unit in the management of cancer patients. Many cancer cases are diagnosed in the first instance as a result of symptoms that lead the patient's admittance into the emergency room. Materials and Methods. This narrative review aims to analyze the impact of acute oncological cases in the emergency setting and the role of the emergency physician in their management. A search was conducted over the period January 1981-April 2023 using the main scientific platforms, including PubMed, Scopus, Medline, Embase and Google scholar, and 156 papers were analyzed. Results. To probe into the main oncological emergencies and their management in increasingly overcrowded emergency departments, we analyzed the following acute pathologies: neurological emergencies, metabolic and endocrinological emergencies, vascular emergencies, malignant effusions, neutropenic fever and anemia. Discussion/Conclusions. Our analysis found that a redefinition of the emergency department connected with the treatment of oncology patients is necessary, considering not only the treatment of the oncological disease in the strict sense, but also the comorbidities, the oncological emergencies and the palliative care setting. The need to redesign an emergency department that is able to manage acute oncological cases and end of life appears clear, especially when this turns out to be related to severe effects that cannot be managed at home with integrated home care. In conclusion, a redefinition of the paradigm appears mandatory, such as the integration between the various specialists belonging to oncological medicine and the emergency department. Therefore, our work aims to provide what can be a handbook to detect, diagnose and treat oncological emergencies, hoping for patient management in a multidisciplinary perspective, which could also lead to the regular presence of an oncologist in the emergency room.
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Affiliation(s)
- Nicole Gri
- Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell’Ospedale Maggiore, 3, 20162 Milano, Italy
| | - Yaroslava Longhitano
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Christian Zanza
- Italian Society of Prehospital Emergency Medicine (SIS 118), 74121 Taranto, Italy
| | - Valentina Monticone
- Department of Otorhinolaryngology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy
| | - Damiano Fuschi
- Department of Italian and Supranational Public Law, School of Law, University of Milan, 20122 Milan, Italy
| | - Andrea Piccioni
- Department of Emergency Medicine, Polyclinic Agostino Gemelli/IRCCS, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Abdelouahab Bellou
- Department of Emergency Medicine, Institute of Sciences in Emergency Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Ciro Esposito
- Unit of Nephrology and Dialysis, ICS Maugeri, University of Pavia, 27100 Pavia, Italy
| | | | - Gabriele Savioli
- Emergency Department, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy
- PhD School in Experimental Medicine, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
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2
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Magacha HM, Parvez MA, Vedantam V, Makahleh L, Vedantam N. Unexplained Hypercalcemia: A Clue to Adrenal Insufficiency. Cureus 2023; 15:e42405. [PMID: 37637567 PMCID: PMC10447631 DOI: 10.7759/cureus.42405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
Hypercalcemia secondary to adrenal insufficiency is a rare condition, but it must be recognized and treated promptly to prevent complications such as kidney damage, bone loss, and cardiac arrhythmias. The co-occurrence of hypercalcemia and adrenal insufficiency can be seen in some rare conditions such as sarcoidosis, however, hypercalcemia as a direct consequence of adrenal insufficiency is well documented in the literature but seldom recognized and often remains underdiagnosed. Symptoms of hypercalcemia in this setting include fatigue, weakness, nausea, vomiting, constipation, abdominal pain, confusion, and dehydration. Treatment typically involves correcting the underlying adrenal insufficiency with hormone replacement therapy, along with measures to lower calcium levels in the blood, such as hydration. In this article, we report the case of a patient presenting with hypercalcemia secondary to adrenal insufficiency.
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Affiliation(s)
- Hezborn M Magacha
- Internal Medicine, East Tennessee State University Quillen College of Medicine, Johnson City, USA
| | - Mohammad A Parvez
- Internal Medicine, East Tennessee State University Quillen College of Medicine, Johnson City, USA
| | - Venkata Vedantam
- Internal Medicine, East Tennessee State University Quillen College of Medicine, Johnson City, USA
| | - Lana Makahleh
- Internal Medicine, East Tennessee State University Quillen College of Medicine, Johnson City, USA
| | - Neethu Vedantam
- Infectious Diseases, East Tennessee State University Quillen College of Medicine, Johnson City, USA
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3
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Muacevic A, Adler JR, Masud A, Patel M, Ramchandani M. An Exciting Case of Acute on Chronic Hypercalcemia in the Setting of Chronic Primary Hyperparathyroidism: A Case Report and Diagnostic Approach. Cureus 2022; 14:e31202. [PMID: 36505117 PMCID: PMC9728625 DOI: 10.7759/cureus.31202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 11/09/2022] Open
Abstract
Acute worsening of hypercalcemia in patients with chronic primary hyperparathyroidism can be challenging, and availability bias may mislead physicians to diagnose worsening primary hyperparathyroidism, especially if the parathyroid hormone is also trending higher. We report a case of stage-IV non-Hodgkin's lymphoma which presented as acute worsening of hypercalcemia in a patient with chronic primary hyperparathyroidism.
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Parathyroid Hormone-Related Peptide (PTHrP): Evaluation of Pediatric, Covariate-Stratified Reference Intervals. CHILDREN 2022; 9:children9060896. [PMID: 35740833 PMCID: PMC9221726 DOI: 10.3390/children9060896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/11/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022]
Abstract
Parathyroid hormone-related peptide (PTHrP) is expressed at a wide range of sites in the body and performs different functions including vasodilation, relaxation of smooth muscle cells, and regulation of bone development. PTHrP also mediates hypercalcemia related to neoplastic diseases. However, reference ranges specific method and age were not evaluated. We establish PTHrP reference ranges in apparently healthy, normocalcemic, normophosphatemic pediatric individuals. In this observational prospective, study we measured PTHrP in serum from 178 samples (55.06% male 44.94% female) from apparently healthy pediatric subjects [median age 10 years (range 1–18)] subunit ELISA method The statistical analysis performed provided for the calculation of the 95% reference interval, right-sided, with a non-parametric percentile method (CLSI C28-A3). Upper reference limits (URL) for PTHrP was 2.89 ng/mL (2.60 to 3.18; 90% CI). No significant differences were found between the median PTHrP concentrations in males vs females and in the age range categories selected. Comprehensive normal values for PTHrP are indispensable to the assessment of calcium phosphorus dysfunction in children. Severe hypercalcemia is a rare, but clinically significant condition, in infancy and childhood. PTHrP values higher than the reference value may help to distinguish the hypercalcemic product of a malignancy, paraneoplastic syndromes mediated by PTHrP, from other causes.
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5
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Chen M, Ni J, Lu X. Hypercalcemia and Osteolytic Lesions as Presenting Symptoms of Acute Lymphoblastic Leukemia in Children: Case Report and Literature Review. Front Pediatr 2022; 10:923297. [PMID: 35757138 PMCID: PMC9218481 DOI: 10.3389/fped.2022.923297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022] Open
Abstract
Acute lymphoblastic leukemia (ALL) presenting with hypercalcemia and osteolytic lesions is rare and unusual in childhood. We report a case of a 13-year-old boy with ALL who presented with intermittent fever, nausea, vomiting, and increasing lower limb pain. Skeletal X-rays and CT scan showed severe osteolytic lesions of the skull and extremities. Physical examination revealed multiple inguinal lymph nodes. Laboratory tests demonstrated severe hypercalcemia (Ca > 3.49 mmol/L), decreased parathyroid hormone (PTH), and vitamin D level. Despite a normal complete blood count and the absence of circulating blasts, bone marrow biopsy revealed B-precursor ALL. Hypercalcemia was initially treated with intravenous isotonic sodium chloride and furosemide but the serum calcium level was not normalized. It was successfully managed with calcitonin and pamidronate afterward. Later, the child responded well to chemotherapy and continued with consolidation treatment. The clinical condition was stable, and the bone marrow revealed complete remission. This case indicated that hypercalcemia alone or combined with osteolytic lesions can be the only presenting symptom of ALL in children. Diagnostic errors may occur especially when combined with the absence of circulating blasts in the peripheral blood smear. Bone marrow aspiration should be considered to confirm the diagnosis.
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Affiliation(s)
- Min Chen
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China.,Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Jiaqi Ni
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China.,Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.,West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Xiaoxi Lu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.,Department of Pediatric Hematology and Oncology, West China Second University Hospital, Sichuan University, Chengdu, China
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6
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Izzedine H, Chazal T, Wanchoo R, Jhaveri KD. Immune checkpoint inhibitor-associated hypercalcaemia. Nephrol Dial Transplant 2020; 37:1598-1608. [PMID: 33374000 DOI: 10.1093/ndt/gfaa326] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Indexed: 01/10/2023] Open
Abstract
Immune checkpoint inhibitors (CPIs) have recently become a cornerstone for the treatment of different advanced cancers. These drugs have the ability to reactivate the immune system against tumour cells but can also trigger a myriad of side effects, termed immune-related adverse events (irAEs). Although there are numerous reports of CPI-related endocrinopathies, hypercalcaemia as a suspected irAE is not well documented. The mechanisms of CPI hypercalcaemia are not clearly established. However, in our review, four distinct causes emerged: endocrine disease-related, sarcoid-like granuloma, humoral hypercalcaemia due to parathyroid-related hormone and hyperprogressive disease following CPI initiation. Prompt recognition of hypercalcaemia and the institution of therapy can be lifesaving, affording the opportunity to address the underlying aetiology. In this review we discuss the incidence, diagnosis and management of immune-related hypercalcaemia in oncological patients receiving CPI agents.
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Affiliation(s)
- Hassan Izzedine
- Department of Nephrology, Peupliers Private Hospital, Ramsay Générale de Santé, Paris, France
| | - Thibaud Chazal
- Department of Internal Medicine, Pitie-Salpetriere Hospital, Paris, France
| | - Rimda Wanchoo
- Division of Kidney Diseases and Hypertension, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Great Neck, NY, USA
| | - Kenar D Jhaveri
- Division of Kidney Diseases and Hypertension, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Great Neck, NY, USA
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7
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Jafari A, Rezaei-Tavirani M, Salimi M, Tavakkol R, Jafari Z. Oncological Emergencies from Pathophysiology and Diagnosis to Treatment: A Narrative Review. SOCIAL WORK IN PUBLIC HEALTH 2020; 35:689-709. [PMID: 32967589 DOI: 10.1080/19371918.2020.1824844] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Oncological emergencies are defined as any acute possible morbid or life-threatening events in patients with cancer either because of the malignancy or because of their treatment. These events may occur at any time during malignancy, from symptoms present to end-stage disease. The aim of this study is the review of urgent conditions results from cancer or cancer treatment side effects that need to be addressed immediately. In this study, a comprehensive and in-depth narrative review was carried out by searching the databases of PubMed, Scopus, Science Direct, Google Scholar with the keywords of "cancer, emergency, metabolic emergency, neutropenic fever" along with the words, "tumor lysis syndrome, chemotherapeutic emergency, diagnosis, treatment " in last two decades. Patients suffering from cancer mostly face the challenges that we are classified in different categories, including metabolic, hematologic, cardiovascular, neurologic, respiratory, infectious, and chemotherapeutic emergencies. These patients mostly complain of headaches, nausea, pain, and fever. In conclusion, knowledge of oncology emergencies and palliative care as part of a team approach is critical for treating cancer patients. In this light, it is pivotal for physicians to focus on the early detection of oncological emergencies. Moreover, training programs for cancer patients help them to timely recognize and report the oncologic emergency symptoms, leading to avoid deleterious consequences and unnecessary healthcare costs as well as improve the quality of life in these patients.
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Affiliation(s)
- Ameneh Jafari
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences , Tehran, Iran
- Proteomics Research Center, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Mostafa Rezaei-Tavirani
- Proteomics Research Center, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Maryam Salimi
- Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Reza Tavakkol
- Department of Nursing, School of Nursing, Larestan University of Medical Sciences , Larestan, Iran
| | - Zahra Jafari
- 9 dey Manzariye Hospital, Isfahan University of Medical Sciences , Isfahan, Iran
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8
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Wu X, Han T, Gao J, Zhang Y, Zhao S, Sun R, Sun C, Niu Y, Li Y. Association of Serum Calcium and Insulin Resistance With Hypertension Risk: A Prospective Population-Based Study. J Am Heart Assoc 2020; 8:e009585. [PMID: 30596304 PMCID: PMC6405709 DOI: 10.1161/jaha.118.009585] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background The temporal sequence between serum calcium and insulin resistance (IR) and their effects on hypertension are unclear. We studied the association between serum calcium and IR, with risk of hypertension events in a longitudinal cohort conducted in China. Methods and Results Data from 8653 subjects aged 20 to 74 years with an average follow‐up of 5.3 years were analyzed. Serum calcium, and fasting and 2‐hour serum glucose and insulin were measured at baseline and follow‐up. Cross‐lagged panel and mediation analysis were used to examine the temporal relationship between serum calcium and IR and its impact on hypertension incidence. The conjoint effects of serum calcium and IR at baseline on hypertension at follow‐up were observed (P=0.029 for HOMA_IR [hepatic IR] and P=0.009 for Gutt index [peripheral IR]). The cross‐lagged path coefficient (β2) from baseline serum calcium to follow‐up peripheral IR were significantly greater than path coefficient (β1) from baseline peripheral insulin resistance to follow‐up serum calcium (β2 =−0.354 versus β1=−0.005; P=0.027). However, no directional relationships were observed in the serum calcium↔hepatic IR analysis. The mediation effect of peripheral IR on the association of serum calcium at baseline with hypertension at follow‐up was estimated at 16.4% (P<0.001). Conclusions Our findings demonstrate that higher serum calcium levels probably precede peripheral IR, and this 1‐directional relation plays a role in the development of hypertension.
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Affiliation(s)
- Xiaoyan Wu
- 1 Department of Nutrition and Food Hygiene the National Key Discipline School of Public Health Harbin Medical University Harbin P. R. China
| | - Tianshu Han
- 1 Department of Nutrition and Food Hygiene the National Key Discipline School of Public Health Harbin Medical University Harbin P. R. China
| | - Jian Gao
- 1 Department of Nutrition and Food Hygiene the National Key Discipline School of Public Health Harbin Medical University Harbin P. R. China
| | - Yunlong Zhang
- 1 Department of Nutrition and Food Hygiene the National Key Discipline School of Public Health Harbin Medical University Harbin P. R. China
| | - Shengnan Zhao
- 1 Department of Nutrition and Food Hygiene the National Key Discipline School of Public Health Harbin Medical University Harbin P. R. China
| | - Rongbo Sun
- 1 Department of Nutrition and Food Hygiene the National Key Discipline School of Public Health Harbin Medical University Harbin P. R. China
| | - Changhao Sun
- 1 Department of Nutrition and Food Hygiene the National Key Discipline School of Public Health Harbin Medical University Harbin P. R. China
| | - Yucun Niu
- 1 Department of Nutrition and Food Hygiene the National Key Discipline School of Public Health Harbin Medical University Harbin P. R. China
| | - Ying Li
- 1 Department of Nutrition and Food Hygiene the National Key Discipline School of Public Health Harbin Medical University Harbin P. R. China
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Colak U, Mutlu GY, Sozmen BO, Yucel EB, Kayserili H, Hatun S. Zoledronate-responsive calcitriol-mediated hypercalcemia in a 5-year-old case with squamous cell carcinoma on the background of xeroderma pigmentosum. J Pediatr Endocrinol Metab 2019; 32:1403-1406. [PMID: 31782950 DOI: 10.1515/jpem-2019-0158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/01/2019] [Indexed: 11/15/2022]
Abstract
Malignancy-induced hypercalcemia is a very rare condition in children whereas it is more common among adult patients with malignancy. The mechanisms of malignancy-induced hypercalcemia include the over-secretion of parathyroid hormone-related protein (PTHrP), osteolytic metastases and the over-production of 1,25-dihydroxyvitamin D (calcitriol). Although hypercalcemia due to PTHrP secretion has been published before, overproduction of calcitriol has not been reported yet in pediatric squamous cell skin carcinoma cases. Herein, we report calcitriol-mediated severe hypercalcemia in a 5-year-old boy with squamous cell skin carcinoma arising in the background of xeroderma pigmentosum (XP) which responded well to zoledronate treatment. To the best of our knowledge, this is the first pediatric case of malignancy-induced hypercalcemia which is mediated by calcitriol in squamous cell skin carcinoma.
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Affiliation(s)
- Ulkem Colak
- Department of Pediatrics, Koc University School of Medicine, Istanbul, Turkey
| | - Gul Y Mutlu
- Koç University Hospital, Davutpaşa Caddesi No. 4, 34010 Topkapi, Istanbul, Turkey.,Division of Pediatric Endocrinology, Department of Pediatrics, Koc University School of Medicine, Istanbul, Turkey, Phone: +90 850 250 8 250
| | - Banu O Sozmen
- Division of Pediatric Hematology, Department of Pediatrics, Koc University School of Medicine, Istanbul, Turkey
| | - Esra B Yucel
- Medical Genetics and Genetic Diseases Diagnostic Center, Koc University School of Medicine, Istanbul, Turkey
| | - Hulya Kayserili
- Medical Genetics and Genetic Diseases Diagnostic Center, Koc University School of Medicine, Istanbul, Turkey
| | - Sukru Hatun
- Division of Pediatric Endocrinology, Department of Pediatrics, Koc University School of Medicine, Istanbul, Turkey
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Bota M, Popa G, Neaga A, Gocan H, Blag CL. Acute Lymphoblastic Leukemia with Malignant Hypercalcemia: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:402-405. [PMID: 30918242 PMCID: PMC6452782 DOI: 10.12659/ajcr.914303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Patient: Female, 6 Final Diagnosis: Acute lymphoblastic leukemia Symptoms: Abdominal pain • bloody diarrhea • malaise • vomiting Medication: — Clinical Procedure: Chemotherapy Specialty: Oncology
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Affiliation(s)
- Mădălina Bota
- Department of Pediatrics, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Gheorghe Popa
- Department of Pediatrics, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Alexandra Neaga
- Department of Pediatrics, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Horatiu Gocan
- Department of Pediatric Surgery and Orthopedics, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Cristina Lucia Blag
- Department of Pediatrics, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
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Klemencic S, Perkins J. Diagnosis and Management of Oncologic Emergencies. West J Emerg Med 2019; 20:316-322. [PMID: 30881552 PMCID: PMC6404710 DOI: 10.5811/westjem.2018.12.37335] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 12/13/2018] [Accepted: 12/13/2018] [Indexed: 02/06/2023] Open
Abstract
Oncologic emergencies may be seen in any emergency department and will become more frequent as our population ages and more patients receive chemotherapy. Life-saving interventions are available for certain oncologic emergencies if the diagnosis is made in a timely fashion. In this article we will cover neutropenic fever, tumor lysis syndrome, hypercalcemia of malignancy, and hyperviscosity syndrome. After reading this article the reader should be much more confident in the diagnosis, evaluation, and management of these oncologic emergencies.
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Affiliation(s)
- Sarah Klemencic
- Virginia Tech Carilion School of Medicine, Department of Emergency Medicine, Roanoke, Virginia
| | - Jack Perkins
- Virginia Tech Carilion School of Medicine, Department of Emergency Medicine, Roanoke, Virginia
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