A 10-year-old boy undergoing chemotherapy presents with fever and severe ankle pain. What compound is most likely elevated due to his symptoms?

In this scenario, the 10-year-old boy undergoing chemotherapy has developed fever and severe ankle pain, which suggests the possibility of tumor lysis syndrome (TLS), a common complication in patients with certain cancers undergoing treatment. TLS occurs when cancer cells rapidly break down and release their intracellular contents into the bloodstream after the initiation of chemotherapy. This breakdown can lead to various metabolic abnormalities.

Uric acid is one of the key compounds that becomes elevated in patients with TLS. When cells are lysed, purines are released and metabolized to uric acid. The rapid increase in uric acid levels can lead to hyperuricemia, which can itself cause pain, particularly in the joints, due to the formation of urate crystals, leading to gout-like symptoms. The severe ankle pain the boy is experiencing could very well be a result of this hyperuricemia.

In addition to uric acid, other metabolic derangements such as hyperkalemia (due to potassium release) and hyperphosphatemia (due to phosphate release) can also occur, but the specific question asks about the compound most likely elevated due to the symptoms described. Therefore, uric acid stands out as the compound that correlates with both the biochemical pathology occurring in TLS and the