RT Journal Article SR Electronic T1 Acute renal failure and type B lactic acidosis as first manifestation of extranodal T-cell lymphoblastic lymphoma JF BMJ Case Reports FD BMJ Publishing Group Ltd SP bcr2014205044 DO 10.1136/bcr-2014-205044 VO 2014 A1 Seongseok Yun A1 Courtney N Walker A1 Nicole D Vincelette A1 Faiz Anwer YR 2014 UL http://casereports.bmj.com/content/2014/bcr-2014-205044.abstract AB We describe a rare case of a 19-year-old male patient with a history of epilepsy and developmental delay who presented with acute renal failure (ARF) and lactic acidosis (LA) as the first manifestation of T-cell lymphoblastic lymphoma. Renal ultrasound and CT of the abdomen showed renal parenchymal infiltration, and renal biopsy demonstrated T-cell lymphoblastic lymphoma. LA, ARF and electrolyte abnormalities were refractory to the initial treatment of bicarbonate infusion and hydration. However, these abnormalities rapidly normalised after the initiation of chemotherapy, suggesting that the LA and ARF were secondary to lymphomatous renal infiltration.