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

2022 ◽  
Vol 50 (1) ◽  
pp. 030006052110677
Author(s):  
Chunhua Wang ◽  
Zanmei Lv ◽  
Yanwei Zhang
Keyword(s):  
Lactic Acidosis ◽  
B Cell ◽  
Warburg Effect ◽  
Cell Lymphoma ◽  
Rare Complication ◽  
B Cell Lymphoma ◽  
Type B ◽  
Large B Cell Lymphoma ◽  
Large B Cell ◽  
The Warburg Effect

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.

scholarly journals Lactic Acidosis and Hypoglycemia in a Patient with Gastric Diffuse Large B-Cell Lymphoma due to the Warburg Effect

2020 ◽  
Vol 13 (2) ◽  
pp. 1047-1052
Author(s):  
Takafumi Hamada ◽  
Toshinari Kaku ◽  
Sumitaka Mitsu ◽  
Yoshinori Morita ◽  
Nobuhito Ohno ◽  
...  
Keyword(s):  
Lactic Acidosis ◽  
B Cell ◽  
Warburg Effect ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Type B ◽  
Severe Lactic Acidosis ◽  
Large B Cell Lymphoma ◽  
Large B Cell ◽  
The Warburg Effect

Lactic acidosis is pathophysiologically classified into type A and type B. The latter is a rare but potentially life-threatening emergency, mainly described in hematological malignancies. The association between Type B lactic acidosis and malignancy is known as the Warburg effect. Patients with the Warburg effect have a very poor prognosis. Herein, we report a case of gastric diffuse large B-cell lymphoma (DLBCL) with severe lactic acidosis and hypoglycemia owing to the Warburg effect that were effectively treated by prompt introduction of chemotherapy. A 73-year-old woman with a 2-month history of abdominal distension was referred to us for suspected peritoneal cancer. Pathological examination revealed gastric DLBCL with peritoneal dissemination. After hospitalization, blood test results revealed prolonged hypoglycemia, with a blood sugar level of 50–70 mg/dL; severe lactic acidosis with pH 7.166; lactate level 12.7 mmol/L; and base excess −21.0 mEq/L, despite continuous administration of glucose and sodium bicarbonate. The cause of lactic acidosis and/or hypoglycemia was considered to be the Warburg effect. We initiated a 50% reduced-dose CHOP (cyclophosphamide, vincristine, doxorubicin, prednisolone) chemotherapy regimen without rituximab until information on the CD20-positive status was available. During chemotherapy, acidosis, hypoglycemia, and impaired consciousness promptly improved. If lactic acidosis or hypoglycemia is present in patients with malignant tumors, it is important to suspect the possibility of the Warburg effect and to introduce cancer treatment as soon as possible.

565: INTRAVASCULAR LARGE B CELL LYMPHOMA PRESENTING AS HEMOPHAGOCYTIC SYNDROME AND TYPE B LACTIC ACIDOSIS

2018 ◽  
Vol 46 (1) ◽  
pp. 267-267
Author(s):  
Gautam Phadke ◽  
Dubert Guerrero ◽  
Avish Nagpal ◽  
Hasrat Khan ◽  
Mazen Kherallah ◽  
...  
Keyword(s):  
Lactic Acidosis ◽  
B Cell ◽  
Hemophagocytic Syndrome ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Type B ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals Lactic acidosis: a unique presentation of diffuse large B-cell lymphoma

2019 ◽  
Vol 12 (10) ◽  
pp. e230277 ◽  
Author(s):  
Turab Jawaid Mohammed ◽  
Rohit Gosain ◽  
Rajeev Sharma ◽  
Pallawi Torka
Keyword(s):  
Lactic Acidosis ◽  
B Cell ◽  
Cell Lymphoma ◽  
Performance Status ◽  
B Cell Lymphoma ◽  
Intrathecal Methotrexate ◽  
Dramatic Improvement ◽  
Metabolic Encephalopathy ◽  
Large B Cell Lymphoma ◽  
Large B Cell

An elderly man in the seventh decade of life was brought to the hospital with worsening mental status. Blood tests revealed anaemia and thrombocytopenia with elevated lactate dehydrogenase and serum lactate levels. CT scan showed bulky thoracic and abdominal lymphadenopathy with splenomegaly. A positron emission tomography scan confirmed the above and in addition, revealed bilateral adrenal involvement. Bone marrow biopsy revealed non-germinal centre B-cell-like (non-GCB)-diffuse large B-cell lymphoma (DLBCL). Prompt treatment with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin and rituximab with intrathecal methotrexate chemotherapy resulted in a dramatic improvement in the patient’s condition. This vignette serves as a reminder to include aggressive lymphomas like DLBCL in the differential diagnoses of patients presenting with metabolic encephalopathy and lactic acidosis. Our patient was moribund at presentation with poor sensorium and failure to thrive. The dilemma was whether to take an aggressive stand and start chemotherapy urgently or whether to stabilise the patient first and then consider the treatment of DLBCL. We make a case for initiating therapy promptly in such patients irrespective of their performance status.

Diffuse large B-cell lymphoma: a rare complication of an abdominal CSF pseudocyst

2017 ◽  
Vol 32 (6) ◽  
pp. 686-687
Author(s):  
Cathal Hannan ◽  
Aaron Niblock ◽  
Jeremy Hamilton ◽  
H. Neil Simms
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Rare Complication ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Large B Cell

LACTIC ACIDOSIS AS THE PRESENTING FEATURE OF LARGE B CELL LYMPHOMA

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 49S
Author(s):  
Brian T. Rice ◽  
Ashkan Amooee ◽  
Maged A. Tanios ◽  
Peter T. Le
Keyword(s):  
Lactic Acidosis ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Large B Cell
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