A patient had the following blood biochemical values. Calcium 6; uric acid 13; Phosphorus 12; Creatinine 6. Which could be the possible diagnosis –
**Core Concept**
Hyperphosphatemia, hyperuricemia, and hypercalcemia in the context of acute kidney injury (AKI) suggest a diagnosis related to tumor lysis syndrome (TLS) or rhabdomyolysis. TLS is characterized by the release of intracellular contents, including nucleic acids, into the bloodstream, leading to the formation of uric acid, phosphate, and other metabolites.
**Why the Correct Answer is Right**
The combination of hyperphosphatemia, hyperuricemia, and hypercalcemia in this patient's blood biochemical values is consistent with TLS. TLS occurs when large numbers of cancer cells die rapidly, releasing their intracellular contents into the bloodstream. This leads to the formation of uric acid, phosphate, and other metabolites, which can cause AKI and other systemic complications. The hyperphosphatemia and hyperuricemia seen in this patient are likely due to the breakdown of nucleic acids and cellular debris.
**Why Each Wrong Option is Incorrect**
**Option A:** While hypercalcemia can occur in various conditions, the combination of hyperphosphatemia, hyperuricemia, and hypercalcemia in the context of AKI is more suggestive of TLS than primary hyperparathyroidism.
**Option B:** Rhabdomyolysis can cause hyperphosphatemia and may also lead to AKI, but it typically does not result in hyperuricemia.
**Option C:** Hyperuricemia can occur in gout, but the combination of hyperphosphatemia and hypercalcemia in this patient's blood biochemical values is not typical of gout.
**Clinical Pearl / High-Yield Fact**
When encountering a patient with AKI, hyperphosphatemia, and hyperuricemia, consider the possibility of TLS, particularly in the context of cancer or rapid cell turnover.
**Correct Answer:** C. Rhabdomyolysis