A 10-year-old boy who has begun chemotherapy for acute myelogenous leukemia awakens at night with fever and severe pain in the ankles. Treatment with over-the-counter analgesics does not resolve the pain. The next morning, he has pain with urination and blood in the urine. Increased degradation of which of the following compounds most likely caused this patient's symptoms?

Question

Quizplus · Accepted Answer

The symptoms are indicative of tumor lysis syndrome, which involves increased degradation of purines leading to hyperuricemia, causing joint pain and uric acid crystals in the urine.  Chemotherapeutic treatment of leukemias often results in tumor lysis syndrome (TLS). TLS is a severe and potentially life-threatening complication in patients with cancer occurring most frequently as a consequence of chemotherapy, radiotherapy, or immunotherapy. The hyperuricemia associated with TLS is the result of significantly increased catabolism of purine nucleotides in the dying cancer cells. The hyperuricemia can lead to acute uric acid nephropathy and kidney failure.

A 10-Year-Old Boy Who Has Begun Chemotherapy for Acute Myelogenous