title: Type B Lactic Acidosis in a Patient with Gastric Adenocarcinoma and Extensive Hepatic Metastases.
abstract: OBJECTIVE
  We report the second case of gastric adenocarcinoma associated with type B lactic acidosis.
  
  
  METHODS
  An 81-year-old man presenting with upper gastrointestinal bleeding was found to have an advanced gastric adenocarcinoma. He had persistently elevated serum lactate attributed to malignancy-associated type B lactic acidosis as a diagnosis of exclusion. As he remained clinically stable with a near-normal pH, his elevated lactate was not specifically treated.
  
  
  CONCLUSIONS
  This patient had an unusual type B lactic acidosis associated with gastric cancer. In the absence of signs and symptoms of other etiologies of lactic acidosis, physicians should consider malignancy-associated type B lactic acidosis.
authors.affiliation: Case Western Reserve University School of Medicine, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Krimmel
authors.forename: Clifford D
authors.initials: CD
authors.lastname: Packer
mesh_terms: D000140:Acidosis, Lactic / Q000209:etiology*; D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology*; D000369:Aged, 80 and over; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary*; D008297:Male; D013274:Stomach Neoplasms / Q000150:complications* / Q000473:pathology*