title: Type B lactic acidosis: a rare but life threatening hematologic emergency. A case illustration and brief review.
abstract: Major strides have been made in improving the treatment of medical emergencies associated with malignancies. Nonetheless, metabolic emergencies in cancer patients can often times be life-threatening. Type B lactic acidosis is a rare but potentially fatal paraneoplastic phenomenon that has been described in association with hematologic and solid malignancies and portends a poor prognosis if not rapidly recognized and treated. It is believed that this occurs as a result of cancer cells switching their glucose metabolism from an oxidative oxygen- dependent pathway towards a glycolytic phenotype, also known as the "Warburg effect". Though rare, it is important to consider this entity in the differential diagnosis of type B lactic acidosis since prompt identification and treatment may help improve outcomes in this otherwise fatal process. We present a case of type B lactic acidosis in a patient with chronic lymphocytic leukemia along with a brief review of the literature.
authors.affiliation: Division of Hematology and Medical Oncology, James Graham Brown Cancer Center, University of Louisville Health Sciences Center Louisville, Kentucky, USA.
authors.forename: Wederson M
authors.initials: WM
authors.lastname: Claudino
authors.affiliation: Division of Hematology and Medical Oncology, James Graham Brown Cancer Center, University of Louisville Health Sciences Center Louisville, Kentucky, USA.
authors.forename: Ajoy
authors.initials: A
authors.lastname: Dias
authors.affiliation: Division of Hematology and Medical Oncology, James Graham Brown Cancer Center, University of Louisville Health Sciences Center Louisville, Kentucky, USA.
authors.forename: William
authors.initials: W
authors.lastname: Tse
authors.affiliation: Division of Hematology and Medical Oncology, James Graham Brown Cancer Center, University of Louisville Health Sciences Center Louisville, Kentucky, USA.
authors.forename: Vivek R
authors.initials: VR
authors.lastname: Sharma
keywords: Lactic acidosis; hematologic emergency; malignancy