2016 Volume 53 Issue 3 Pages 305-308
We report a pediatric case of B-cell precursor acute lymphoblastic leukemia with hyperkalemia and ventricular tachycardia (VT) caused by spontaneous tumor lysis syndrome. A 10-year-old girl was brought to our hospital by ambulance because of generalized clonic seizure and pallor. On arrival, her blood pressure was too low to measure. Her laboratory findings were as follows: WBC count, 30,830/μL (blast 91%); RBC count, 149×104/μL; Hb level, 4.5 g/dL; Ht, 13.3%; Plt count, 1.0×104/μL; LD level, 4,125 IU/L; uric acid level, 46.1 mg/dL; urea level, 85 mg/dL; Cr level, 1.85 mg/dL; K level, 9.7 mEq/L; Ca level, 5.8 mg/dL; and P, 26.3 mg/dL. ECG showed ventricular tachycardia. Two and a half hours later, hemodialysis was started; then arrhythmia immediately disappeared and her blood pressure normalized. Flow cytometry of the peripheral blood blasts confirmed the presence of cells positive for CD10, CD19, and HLA-DR, which is the characteristic immunophenotype of B-cell precursor acute lymphoblastic leukemia.
