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Acute Reversible Tetraplegia Induced by Hyperkalemia in a Patient with Paravertebral Mass due to Lymphoma

Abstract

Gabriel Tinoco, Rehan Kanji, Izidore S Lossos and Peter J Hosein

Acute onset of tetraplegia is a medical emergency. Hyperkalemia has been described as a very uncommon cause of tetraplegia. A 79 year old male presented with an acute onset of tetraplegia. His past medical history was significant for stage III follicular lymphoma diagnosed 4 years ago that 1 month prior to the admission progressed with biopsy-proven transformation to a diffuse large B-cell lymphoma. Recent CT and PET scans revealed multiple active lesions including a large paravertebral mass measuring 29 cm?12 cm?7 cm starting in the axial level of the diaphragm involving left psoas, the left renal vein and encasing the aorta. Multiple skeletal lesions, as well as numerous lymph nodes were found. The liver and spleen were also compromised. His surgical history was remarkable for radical prostatectomy for localized prostate cancer. The patient did not have previous history of renal failure and his blood urea nitrogen and creatinine were within normal range (15 mg/dL and 0.8 mg/dL, respectively).

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