Chan Farn Huei, Carl Daniel, Lyckholm Laurel J
Department of Internal Medicine, Division of Hematology, Oncology and Palliative Care, Virginia Commonwealth University, Richmond, VA 23298, USA.
Case Rep Med. 2009;2009:534561. doi: 10.1155/2009/534561. Epub 2010 Jan 4.
Lactic acidosis is commonly observed in clinical situations such as shock and sepsis, as a result of tissue hypoperfusion and hypoxia. Lymphoma and leukemia are among other clinical situations where lactic acidosis has been reported. We present a case of a 59-year-old female with lactic acidosis who was found to have aggressive B-cell lymphoma. There have been 29 cases of lymphoma induced lactic acidosis reported thus far; however all reported cases have abnormal vital signs or concomitant medical conditions that may lead to lactic acidosis. The pathogenesis of malignancy-induced lactic acidosis is not well understood; however associated factors include increased glycolysis, increased lactate production by cancer cells, and decreased hepatic clearance of lactate. When it occurs, lactic acidosis is a poor prognostic sign in these patients. Prompt diagnosis and treatment of underlying lymphoma or leukemia remains the only way to achieve complete resolution of lactic acidosis in these patients.
乳酸酸中毒常见于休克和脓毒症等临床情况，是组织灌注不足和缺氧的结果。淋巴瘤和白血病是其他已报告出现乳酸酸中毒的临床情况。我们报告一例59岁患有乳酸酸中毒的女性，她被发现患有侵袭性B细胞淋巴瘤。迄今为止，已有29例淋巴瘤诱发乳酸酸中毒的病例报告；然而，所有报告的病例都有异常生命体征或可能导致乳酸酸中毒的伴随疾病。恶性肿瘤诱发乳酸酸中毒的发病机制尚不完全清楚；但相关因素包括糖酵解增加、癌细胞乳酸生成增加以及肝脏对乳酸的清除减少。乳酸酸中毒一旦发生，对这些患者来说是预后不良的迹象。及时诊断和治疗潜在的淋巴瘤或白血病仍然是这些患者乳酸酸中毒完全缓解的唯一途径。
