A 28-year-old woman was found to have stage IV Burkitt"s lymphoma. Her renal function was normal and a staging CT scan had shown no abnormality of the renal tract. Three days later, when she was about to start chemotherapy, she developed a temperature of 39.0°C with rigors and was treated with imipenem. Investigations (the following day):
$\begin{array}{ll}
\text { serum sodium } & 138 \mathrm{mmol} / \mathrm{L}(137-144) \
\text { serum potassium } & 6.2 \mathrm{mmol} / \mathrm{L}(3.5-4.9) \
\text { serum creatinine } & 215 \mu \mathrm{mol} / \mathrm{L}(60-110) \
\text { serum corrected calcium } & 1.60 \mathrm{mmol} / \mathrm{L}(2.20-2.60) \
\text { serum phosphate } & 1.52 \mathrm{mmol} / \mathrm{L}(0.8-1.4) \
\text { serum lactate dehydrogenase } & 1238 \mathrm{U} / \mathrm{L}(10-250) \
\text { serum urate } & 0.69 \mathrm{mmol} / \mathrm{L}(0.19-0.36)
\end{array}$ What is the most likely cause of the renal impairment?

Question

Quizplus · Accepted Answer

The patient's elevated serum potassium, creatinine, phosphate, and urate levels, along with a decreased calcium level and a significantly increased lactate dehydrogenase (LDH), are indicative of tumor lysis syndrome. This condition occurs when cancer cells break down rapidly, releasing their contents into the bloodstream, leading to metabolic abnormalities.

A 28-Year-Old Woman Was Found to Have Stage IV Burkitt"s