title: Lactic acidosis and hypoglycemia with ALL relapse following engrafted bone marrow transplant.
abstract: Lactic acidosis together with hypoglycemia in the face of hematologic malignancy is a grave development. A 7-year-old male with pre-B-cell ALL following hematopoietic cell transplant was admitted to our hospital in his second relapse. On hospital days 4 and 5, he developed refractory hypoglycemia, lactic acidosis, central respiratory failure, and acute renal failure. Bicarbonate infusion, B vitamins, and hemodialysis were not effective. Care was withdrawn on hospital day 9. Further understanding of the mechanisms that cause the combined onset of lactic acidosis and hypoglycemia will help clinicians in implementing timely therapies that may reduce mortality.
authors.affiliation: Division of Hematology-Oncology, Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota 55455, USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Luscri
authors.forename: Michael
authors.initials: M
authors.lastname: Mauer
authors.forename: Kyriakie
authors.initials: K
authors.lastname: Sarafoglou
authors.forename: Antoinette
authors.initials: A
authors.lastname: Moran
authors.forename: Jakub
authors.initials: J
authors.lastname: Tolar
mesh_terms: D000140:Acidosis, Lactic / Q000209:etiology*; D016026:Bone Marrow Transplantation; D002648:Child; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000628:therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000628:therapy*