19th February 2025

A 66-year-old woman has been referred in for neurological assessment by her GP. She has noticed a 2-day history of a “pins and needles” sensation

A 66-year-old woman has been referred in for neurological assessment by her GP. She has noticed a 2-day history of a “pins and needles” sensation in her upper arms, as well as some muscle twitching. Her past medical history includes diabetes and acute myeloid leukaemia, for which she is receiving treatment with chemotherapy under the haematology team. Her current medications include amlodipine, allopurinol, ramipril and metformin. A CT head has been performed that was unremarkable.

Bloods reveal:  Na 135 mmol/L (133-146 mmol/L), K 5.9 mmol/L (3.5-5.3 mmol/L), Creatinine 120 µmol/L (45-104 µmol/L), Urea 4.8 mmol (2.5-7.8 mmol/L), PO4 1.6 mmol/L (0.80-1.50 mmol/L), Ca 1.35 mmol/L (2.20-2.60 mmol/L), uric acid 600 µmol/L (150-480 µmol/L).

What is the most likely cause of her deranged blood tests?

Select the SINGLE most appropriate option from the list below. Select ONE option only.