Relapsed mantle cell lymphoma presenting with lactic acidosis and hypoglycemia: A case report

Abstract

Lactic acidosis and hypoglycemia are rare presentations of malignancy with a poor prognosis. We present the case of a mantle cell lymphoma patient who relapsed with lactic acidosis and hypoglycemia. Although blood glucose, pH, and lactate normalized following chemotherapy and intensive care support, the patient died from ventilator‐associated pneumonia.

B-cell hepatosplenic lymphoma presenting in adult patient after spontaneous splenic rupture followed by severe persistent hypoglycaemia: type B lactic acidosis and acute liver failure

“…Treatment of acidosis with bicarbonate alone remains controversial but may improve the circulatory system. Bicarbonate can theoretically increase lactate formation and, thereby, potentially worsen the patient’s clinical condition 1 6 8. Administration of thiamine, even in cases with normal serum levels, is thought to drive pyruvate towards the synthesis of acetyl-CoA instead of lactic acid.…”

“…Lactic acidosis (LA) with persistent hypoglycaemia is a rare but known complication of haematological malignancies such as lymphoma and leukaemia and may possibly be explained by the Warburg effect. The Warburg effect is caused by a high glucose uptake and glycolysis in cancer cells leading to low blood glucose and lactate acidosis despite aerobic conditions 1–7…”