| Abstract | A 32-year-old man who had undergone kidney transplantation presented with malaise, severe diarrhoea, nausea and vomiting, productive cough and shortness of breath. A 42-year-old woman with no relevant medical history presented with fever, weight loss and abdominal pain. Both patients had lactic acidosis and hypoglycaemia. Initially, the hyperlactataemia was thought to result from tissue hypoxia (sepsis) but it persisted after correction of the hypovolaemia; therefore, alternative causes were considered. Both patients were found to have T-cell lymphoma with liver infiltration. The male patient died before treatment could be initiated. The lactic acidosis resolved in the female patient following lymphoma treatment, but she died subsequently from the lymphoma. Lymphoreticular malignancies should be considered for cases of lactic acidosis with sufficient oxygen supply, particularly when hypoglycaemia is also present. The lactic acidosis and hypoglycaemia result from increased anaerobic glycolysis in tumour cells. Tumour reduction with chemotherapy can reduce the lactic acidosis. |
| Authors | N P Juffermans, A W Rijneveld, S Zweegman, J J Spijkstra
(Affiliation: Academisch Medisch Centrum/Universiteit van Amsterdam. n.p.juffermans at amc.uva.nl)
|
| Journal | Nederlands tijdschrift voor geneeskunde
(Ned Tijdschr Geneeskd)
Vol. 150
Issue 50
Pg. 2770-3
(Dec 16 2006)
ISSN: 0028-2162 Netherlands |
| Vernacular Title | Twee patiënten met lactaatacidose en hypoglykemie als uiting van een lymfoom. |
| PMID | 17225791
(Publication Type: Case Reports, English Abstract, Journal Article)
|
| Topics |
- Acidosis, Lactic
(diagnosis, etiology)
- Adult
- Fatal Outcome
- Female
- Humans
- Hypoglycemia
(diagnosis, etiology)
- Liver Neoplasms
(diagnosis, secondary)
- Lymphoma, T-Cell
(complications, diagnosis)
- Male
|
