Abstract
An extreme hyperkalemia, hyperphosphatemia and hypocalcemia were developed following the induction therapy with prednisolone and vincristine in a case of acute lymphatic leukemia Serum potassium reached to 9.1 mEq/L. and phosphate to 12.5 mg/dl. and calcium decreased to 6.3 mg/dl. These electrolyte abnormalities changed in parallel with the increase of blood urea-nitrogen, creatinine and uric acid. At the same time, plasma renin activity and aldosterone levels increased in parallel with blood pressure. There were also the vasopressin-resistent polyuria. Before these changes occurred, the leukemic cells in peripheral blood decresed rapidly from 523,000/cmm to 25,000/cmm within four days.
The cause of these changes was suspected to be a result of the sudden lysis of a large number of leukemic cells. Sudden occurrence of hyperkalemia and the presence of polyuria denied the idea that the electrolyte changes were simply due to the renal inssufficiency.
