Unusual presentation of acute kidney injury with Tumour Lysis Syndrome

Tumour lysis syndrome (TLS) can cause acute kidney injury (AKI) by the breakdown of intracellular contents during treatment for malignancies with large tumour burden. We report a case with an unusual presentation of AKI needing renal replacement therapy. Investigation of the cause for AKI led to the diagnosis of an underlying malignancy (lymphoma). Treatment of a Bell’s palsy with steroids before presenting to our service has caused the AKI giving us the overarching diagnosis of TLS in this patient with lymphoma.