title: Lactic acidosis and hypoglycemia: a metabolic complication of advanced gynecologic malignancy.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Brigham & Women's and Beth Israel Hospitals, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: H.G.
authors.initials: HG
authors.lastname: Muntz
authors.forename: E.
authors.initials: E
authors.lastname: Brown