Acute tumour lysis syndrome with extreme metabolic abnormalities

Summary Tumour lysis syndrome, manifested by various metabolic derangements, is a known complication after treatment of some lymphoid malignancies. A patient is reported with acute lymphocytic leukaemia who developed a tumour lysis syndrome following intensive chemotherapy. All the known complications of the syndrome were present in the most severe form—hyperuricaemia of 1.44 mmol/l, hyperphosphataemia of 7.7 mmol/l with acute oliguric renal failure and extreme hyperkalaemia of 9.8 mmol/l with electrocardiographic changes. This life‐threatening condition did not respond to conservative measures and the patient recovered only after haemodialysis.