In tumor lysis syndrome, which electrolyte imbalance is likely to occur?

Tumor lysis syndrome is a metabolic emergency that can occur after the rapid destruction of tumor cells, often in response to chemotherapy or radiation therapy. This condition leads to the release of intracellular contents into the bloodstream, causing several metabolic abnormalities. One of the primary electrolyte imbalances seen in tumor lysis syndrome is hyperkalemia, which is an elevated level of potassium in the blood.

The reason hyperkalemia is likely to occur is due to the large amounts of potassium that are stored within cells. When tumor cells are lysed, particularly in conditions involving high cell turnover, such as hematologic malignancies, potassium is released into the circulation. This can lead to significant complications, including cardiac arrhythmias, as excessive potassium levels can disrupt normal heart rhythm.

While other imbalances, such as hypomagnesemia, hypercalcemia, and hypochloremia, may occur in different contexts or due to other mechanisms, they are not as characteristic of tumor lysis syndrome as hyperkalemia. Hypomagnesemia generally refers to low levels of magnesium and could be influenced by other factors, while hypercalcemia, which is an elevated calcium level, is more commonly associated with certain malignancies rather than the rapid cell breakdown seen in this syndrome.