Saturday, February 24, 2018

Tumor lysis syndrome and rhabdomyolysis: Why does calcium decrease?

Doubt in response to you post on tumor lysis syndrome: What is the mechanism behind hyperphosphatemia causing hypocalcemia in tumor lysis syndrome? Wouldn’t the tumor cells also release calcium, thus leading to hypercalcemia? Asked via email

I think it mostly has to do with the physiology.

Calcium is found mainly in the extracellular fluids whilst phosphorous is found mostly in the intracellular fluids.

Therefore, when cells lyse (in tumor lysis syndrome) or when muscle is broken down (in rhabdomyolysis), there is an efflux of cellular material rich in potassium, phosphorus, and uric acid into the bloodstream. Hypocalcemia is attributed to intracellular phosphate forming complexes with free calcium after it is released into the blood stream.

Hope that clears your doubt!


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