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与弥漫性大 B 细胞淋巴瘤和沃伯格效应相关的 B 型乳酸酸中毒。

Type B lactic acidosis associated with diffuse large B-cell lymphoma and the Warburg effect.

机构信息

Department of Gastroenterology, The 980th Hospital of the People's Liberation Army Joint Service (Bethune International Peace Hospital), Shijiazhuang, Hebei, China.

Department of Diagnostic Radiology, The 980th Hospital of the People's Liberation Army Joint Service (Bethune International Peace Hospital), Shijiazhuang, Hebei, China.

出版信息

J Int Med Res. 2022 Jan;50(1):3000605211067749. doi: 10.1177/03000605211067749.

Abstract

Type B lactic acidosis is a rare complication of non-tissue perfusion abnormalities caused by solid tumors or hematologic malignancies. Herein, we present the case of a 42-year-old man with type B lactic acidosis and hypoglycemia who was found to have a diffuse large B-cell lymphoma. The cause of lactic acidosis and/or hypoglycemia is thought to be the Warburg effect, which is when the metabolic rate of a rapidly growing malignant tumor is very high and dominated by glycolysis. Systemic damage from type B lactic acidosis can occur when the increased rate of glycolysis exceeds the normal muscle and liver lactic acid clearance rate. The Warburg effect is a rare but serious condition that needs to be recognized, not only in diffuse large B-cell lymphoma, but also in other malignancies. The prognosis of lactic acidosis in patients with malignant tumors is very poor. Currently, effective chemotherapy seems to be the only hope for survival.

摘要

B 型乳酸酸中毒是由实体瘤或血液系统恶性肿瘤引起的非组织灌注异常的罕见并发症。本文报道了 1 例 42 岁男性,因弥漫性大 B 细胞淋巴瘤而发生 B 型乳酸酸中毒和低血糖。乳酸酸中毒和/或低血糖的原因被认为是瓦博格效应,即快速生长的恶性肿瘤的代谢率非常高,并且由糖酵解主导。当糖酵解的增加速度超过正常肌肉和肝脏乳酸清除率时,就会发生全身性的 B 型乳酸酸中毒损伤。瓦博格效应是一种罕见但严重的病症,不仅在弥漫性大 B 细胞淋巴瘤中,而且在其他恶性肿瘤中也需要得到识别。恶性肿瘤患者的乳酸酸中毒预后非常差。目前,有效的化疗似乎是唯一的生存希望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84d0/8743961/c1f6f3befb37/10.1177_03000605211067749-fig1.jpg

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