title: [Type B lactic acidosis associated with marginal lymphoma of the spleen: report of one case].
abstract: Lactic acidosis in the absence of hypoxia or tissue hypoperfusion (type B) is very rare and is associated with the use of some drugs or malignancy. We report a 79-year-old woman, with a marginal non-Hodgkin's lymphoma of the spleen that was subjected to a splenectomy one year ago. She presented with unexplained tachypnea associated with pancytopenia and elevation of IgM to 10 times over the higher normal limit. Laboratory tests showed the presence of metabolic acidosis and high lactic acid levels in the absence of infection, tissue hypoxia or hypoperfusion. She was treated with sodium bicarbonate and steroids without obtaining a reduction in lactate levels. Twelve days after admission, a single dose of Rituximab quickly normalized lactate concentrations and platelet count. After the fourth dose of Rituximab, pancytopenia disappeared and IgM fell to 25% of its baseline concentration.
authors: Sección de Nefrología, Servicio de Medicina Interna, Hospital Naval A. Nef, Viña del Mar, Chile. jvegastieb@gmail.com
authors: Jorge
authors: J
authors: Vega
authors: María de los Ángeles
authors: Mde L
authors: Rodríguez
authors: Armando
authors: A
authors: Peña
authors: Alejadro
authors: A
authors: Vásquez
mesh_terms: D000140:Acidosis, Lactic / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D019344:Lactic Acid / Q000378:metabolism; D008228:Lymphoma, Non-Hodgkin / Q000150:complications*; D010198:Pancytopenia / Q000188:drug therapy; D000069283:Rituximab; D013160:Splenic Neoplasms / Q000150:complications*
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D007075:Immunoglobulin M; D019344:Lactic Acid; D000069283:Rituximab