A 12-year-old boy with Burkitt lymphoma starts induction chemotherapy. Two days later he develops oliguria with potassium 6.8 mEq/L, phosphate 9.2 mg/dL, calcium 6.4 mg/dL, uric acid 16 mg/dL, and creatinine 3.1 mg/dL. Along with hydration and cardiac protection, the specific agent indicated to lower uric acid rapidly is:
- A Allopurinol
- B Rasburicase ✓
- C Febuxostat
- D Probenecid
Correct answer: B. Rasburicase
Explanation
Tumor lysis syndrome with symptomatic hyperuricaemia and AKI requires rasburicase, a recombinant urate oxidase that converts insoluble uric acid to soluble allantoin and lowers levels within hours. Allopurinol and febuxostat only block new xanthine formation, do not remove existing urate, and allopurinol causes xanthine accumulation. Probenecid reduces urate excretion and is contraindicated here.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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