Lactic acidosis and hypoglycemia: a metabolic complication of advanced gynecologic malignancy.
Refractory lactic acidosis and hypoglycemia characterize a paraneoplastic syndrome observed in advanced gynecologic cancer, as illustrated by a patient with a large malignant mixed Mullerian tumor. Massive infusions of sodium bicarbonate and glucose failed to reverse her metabolic abnormalities, and the patient suffered a rapidly fatal course. The biochemical basis for this metabolic complication is reviewed, including how medical intervention can lead to iatrogenic exacerbation of the metabolic imbalance.
Muntz
H.G.
HG
Department of Obstetrics and Gynecology, Brigham & Women's and Beth Israel Hospitals, Harvard Medical School, Boston, Massachusetts, USA.
Brown
E.
E