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Type B Lactic Acidosis in a Patient with Mantle Cell Lymphoma

Type B lactic acidosis is an uncommon medical emergency in which acid production overwhelms hepatic clearance. This specific etiology of lactic acidosis occurs without organ hypoperfusion and has been most commonly described in patients with hematologic malignancies but also in patients with solid t...

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Autores principales: Nzenwa, Ikemsinachi C., Berquist, Margaret, Brenner, Toby J., Ansari, Aida, Al-Fadhl, Hamid D., Aboukhaled, Michael, Patel, Shivani S., Peck, Ethan E., Al-Fadhl, Mahmoud D., Thomas, Anthony V., Zackariya, Nuha, Walsh, Mark M., Bufill, Jose A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10447056/
https://www.ncbi.nlm.nih.gov/pubmed/37621746
http://dx.doi.org/10.1155/2023/7021123
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author Nzenwa, Ikemsinachi C.
Berquist, Margaret
Brenner, Toby J.
Ansari, Aida
Al-Fadhl, Hamid D.
Aboukhaled, Michael
Patel, Shivani S.
Peck, Ethan E.
Al-Fadhl, Mahmoud D.
Thomas, Anthony V.
Zackariya, Nuha
Walsh, Mark M.
Bufill, Jose A.
author_facet Nzenwa, Ikemsinachi C.
Berquist, Margaret
Brenner, Toby J.
Ansari, Aida
Al-Fadhl, Hamid D.
Aboukhaled, Michael
Patel, Shivani S.
Peck, Ethan E.
Al-Fadhl, Mahmoud D.
Thomas, Anthony V.
Zackariya, Nuha
Walsh, Mark M.
Bufill, Jose A.
author_sort Nzenwa, Ikemsinachi C.
collection PubMed
description Type B lactic acidosis is an uncommon medical emergency in which acid production overwhelms hepatic clearance. This specific etiology of lactic acidosis occurs without organ hypoperfusion and has been most commonly described in patients with hematologic malignancies but also in patients with solid tumors. The mechanism by which cancer cells switch their glucose metabolism toward increasingly anaerobic glycolytic phenotypes has been described as the “Warburg effect.” Without treating the underlying malignancy, the prognosis for patients diagnosed with malignancy-related type B lactic acidosis is extremely poor. Here, we present a case of a 66-year-old male who was diagnosed with type B lactic acidosis secondary to mantle cell lymphoma. Bicarbonate drip was started to correct the lactic acidosis. The patient was also immediately treated with rituximab chemotherapy combined with rasburicase to avoid the hyperuricemia associated with tumor lysis syndrome. He responded to the early treatment and was discharged with normal renal function. Type B lactic acidosis secondary to hematologic malignancy is important to recognize. In order to successfully treat this syndrome, early diagnosis and simultaneous treatment of the imbalance of lactic acid levels and the underlying malignancy are necessary.
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spelling pubmed-104470562023-08-24 Type B Lactic Acidosis in a Patient with Mantle Cell Lymphoma Nzenwa, Ikemsinachi C. Berquist, Margaret Brenner, Toby J. Ansari, Aida Al-Fadhl, Hamid D. Aboukhaled, Michael Patel, Shivani S. Peck, Ethan E. Al-Fadhl, Mahmoud D. Thomas, Anthony V. Zackariya, Nuha Walsh, Mark M. Bufill, Jose A. Case Rep Crit Care Case Report Type B lactic acidosis is an uncommon medical emergency in which acid production overwhelms hepatic clearance. This specific etiology of lactic acidosis occurs without organ hypoperfusion and has been most commonly described in patients with hematologic malignancies but also in patients with solid tumors. The mechanism by which cancer cells switch their glucose metabolism toward increasingly anaerobic glycolytic phenotypes has been described as the “Warburg effect.” Without treating the underlying malignancy, the prognosis for patients diagnosed with malignancy-related type B lactic acidosis is extremely poor. Here, we present a case of a 66-year-old male who was diagnosed with type B lactic acidosis secondary to mantle cell lymphoma. Bicarbonate drip was started to correct the lactic acidosis. The patient was also immediately treated with rituximab chemotherapy combined with rasburicase to avoid the hyperuricemia associated with tumor lysis syndrome. He responded to the early treatment and was discharged with normal renal function. Type B lactic acidosis secondary to hematologic malignancy is important to recognize. In order to successfully treat this syndrome, early diagnosis and simultaneous treatment of the imbalance of lactic acid levels and the underlying malignancy are necessary. Hindawi 2023-08-16 /pmc/articles/PMC10447056/ /pubmed/37621746 http://dx.doi.org/10.1155/2023/7021123 Text en Copyright © 2023 Ikemsinachi C. Nzenwa et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Nzenwa, Ikemsinachi C.
Berquist, Margaret
Brenner, Toby J.
Ansari, Aida
Al-Fadhl, Hamid D.
Aboukhaled, Michael
Patel, Shivani S.
Peck, Ethan E.
Al-Fadhl, Mahmoud D.
Thomas, Anthony V.
Zackariya, Nuha
Walsh, Mark M.
Bufill, Jose A.
Type B Lactic Acidosis in a Patient with Mantle Cell Lymphoma
title Type B Lactic Acidosis in a Patient with Mantle Cell Lymphoma
title_full Type B Lactic Acidosis in a Patient with Mantle Cell Lymphoma
title_fullStr Type B Lactic Acidosis in a Patient with Mantle Cell Lymphoma
title_full_unstemmed Type B Lactic Acidosis in a Patient with Mantle Cell Lymphoma
title_short Type B Lactic Acidosis in a Patient with Mantle Cell Lymphoma
title_sort type b lactic acidosis in a patient with mantle cell lymphoma
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10447056/
https://www.ncbi.nlm.nih.gov/pubmed/37621746
http://dx.doi.org/10.1155/2023/7021123
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