侵袭性淋巴瘤中沃伯格效应的临床表现：病例报告。
Clinical presentation of Warburg effect in aggressive lymphoma: a case report.
机构信息
Department of Hematology and Oncology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
Division of Gastroenterology and Hepatology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA.
出版信息
J Med Case Rep. 2023 Aug 23;17(1):380. doi: 10.1186/s13256-023-04079-6.
BACKGROUND
The Warburg effect is a rare condition in tumor biology, illustrated by significant lactate production in the presence of oxygen. The Warburg effect is associated with very poor prognosis in patients with malignancy.
CASE PRESENTATION
We report a 76-year-old Caucasian woman with double-expressor diffuse large B cell lymphoma who presented with severe lactic acidosis and extreme hypoglycemia with normal mentation. Her lactic acidosis was initially controlled with a bicarbonate infusion, and the patient was started promptly on steroids, followed by chemotherapy, but her clinical course was complicated by tumor lysis syndrome, acute renal failure requiring hemodialysis, and progressive liver failure. She manifested a temporary clinical response to chemotherapy but eventually died of complications.
CONCLUSIONS
This case demonstrates the importance of prompt recognition of the Warburg effect, aggressive supportive measures, and early initiation of chemotherapy. Future studies are needed to characterize the role of hemodialysis in this setting.
背景
沃伯格效应是肿瘤生物学中的一种罕见现象，其特征是在存在氧气的情况下大量产生乳酸。沃伯格效应与恶性肿瘤患者的预后极差相关。
病例介绍
我们报告了一例 76 岁的高加索裔女性，患有双表达弥漫性大 B 细胞淋巴瘤，表现为严重的乳酸酸中毒和极度低血糖但神志正常。她的乳酸酸中毒最初通过碳酸氢盐输注得到控制，随后迅速开始使用类固醇治疗，接着进行化疗，但她的病情随后出现肿瘤溶解综合征、需要血液透析的急性肾衰竭和进行性肝功能衰竭等并发症。她的临床症状在化疗后暂时得到缓解，但最终死于并发症。
结论
本病例表明，及时认识到沃伯格效应、积极的支持性治疗措施和早期开始化疗非常重要。需要进一步研究来确定血液透析在此情况下的作用。
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