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Oncologic Emergencies - Differential Diagnosis Framework

HEMATOLOGIC ONCOLOGIC EMERGENCIES:
Hyperviscosity Syndrome:
 • Spontaneous bleeding
 • Shortness of breath
Diagnosis Framework HEMATOLOGIC ... Hyperviscosity Syndrome ... death Neutropenic Fever ... Superior Vena Cava Syndrome ... : Tumor Lysis Syndrome
Summary of Oncologic Emergencies

Neutropenic fever:
- Fever + ANC < 500 → start cefepime ± vancomycin (if
Neutropenic fever ... : - Fever + ANC ... ): - Hematologic ... or HSCT - CRS: fever ... therapy - Symptoms: fever
Interstitial pneumonias
An acute reticular pattern is most frequently caused by interstitial edema due to cardiac heart
most frequently caused ... The other cause ... cough and some fever ... #Clinical #Radiology ... #CXR #Acute #Interstitial
Macrophage Activation Syndrome (MAS)
Classified among the secondary or acquired forms of haemophagocytic lymphohistiocytosis (sHLH)

What?
A subset of
disease • Periodic fever ... syndromes Clinical ... multiorgan failure • Fever ... - Nonremitting fever ... Treatment: • Corticosteroids
Sweet Syndrome

Acute febrile neutrophilic dermatosis (Sweets Syndrome) is a skin condition characterized by fever and inflamed
characterized by fever ... Disorder: - Fever ... Symptoms: - Fever ... arthralgia) - Fever ... #oncology
Leukostasis vs Tumor Lysis Syndrome
Leukostasis:
 • Pathophysiology: Large, immature blasts and high WBC count cause hyperviscosity
high WBC count cause ... , dyspnea, +/- CXR ... - 80% have fever ... organ damage • Treatment ... diagnosis #management #hematology
Kerion
Raised, boggy lesion with heaped up purulent nodules 
Caused by host's response to a fungal ringworm
purulent nodules Caused ... mentagrophytes) Clinical ... Hair loss • Fever ... Lymphadenopathy Treatment ... Griseofulvin #Kerion #Dermatology
Differentiation Syndrome in APML
Epidemiology:
 • Incidence: common in APL (2-48% depending on the study)
 • Triggers:
Differentiation Syndrome ... Subacute-Acute: • Common: fever ... common • Imaging: CXR ... diagnosis #management #hematology ... #oncology
TRALI vs TACO - Transfusion Reactions
TRALI:
 • Epidemiology: 0.1% of transfused patientsl
 • Risk factors: Critical
without other cause ... explain symptoms • Fever ... fluid balance, and CXR ... pulmonary edema) • Fever ... Transfusion #Reactions #hematology
Aplastic Anemia - Overview

Who?
• M = F
• 3 peaks:	1) Childhood	2) 15-25 years	3) >60 years

What?
• Aplastic anemia
Aplastic Anemia Clinical ... Presentation: • Fever ... and petechiae Causes ... Aplastic #Anemia #oncology ... #hematology #diagnosis