When metabolic emergencies collide: A case of concurrent diabetic ketoacidosis and tumor lysis syndrome.
Anthony Acosta, Travis Yamanaka, Natalie Cairo et al.
✦ AI-curated · Sources linked
Case in brief
An 82-year-old man with extensive-stage small cell lung cancer presented to the emergency department five days after chemotherapy with symptoms including vomiting, hypotension, and tachypnea. He was found to have severe metabolic acidosis, hyperglycemia, acute kidney injury, and laboratory findings consistent with both diabetic ketoacidosis and tumor lysis syndrome. The patient was admitted to the ICU and treated with insulin, hydration, and rasburicase.
What made this case unusual
This case highlights the rare occurrence of concurrent diabetic ketoacidosis and tumor lysis syndrome in a patient with small cell lung cancer, which is not commonly reported in solid tumors.
Diagnostic / clinical pearl
Clinicians should consider the possibility of tumor lysis syndrome in patients with chemosensitive malignancies presenting with diabetic ketoacidosis and acute kidney injury.
Why it matters
Recognizing concurrent tumor lysis syndrome can lead to timely disease-specific interventions, improving patient outcomes in complex cases.