We report 2 patients with HIV-associated non-Hodgkin’s lymphoma with massive hepatic involvement and lactic acidosis. The lactic acidosis was likely caused by excessive tumor lactate production coupled with impaired hepatic clearance. Although 1 patient died rapidly, the other survived for 7 months after receiving urgent combination chemotherapy. Clinicians should be aware of this condition and the importance of its early diagnosis and treatment.
Sillos EM, Shenep JL, Burghen GA, Pui C., Behm FG, Sandlund JTLactic acidosis: a metabolic complication of hematologic malignancies: case report and review of the literature. Cancer. 2001;92(9):2237-2246.
2.
Lettieri CJ, Berg BWClinical features of non-Hodgkins lymphoma presenting with acute liver failure: a report of five cases and review of published experience. Am J Gastroenterol. 2003; 98(7):1641-1646.
3.
Krause J.AIDS-related non-Hodgkin’s lymphomas. Microsc Res Tech . 2005;68(3-4):168-175.
4.
El-Sadr WM, Lundgren JD, Neaton JD, et al. CD4+ count-guided interruption of antiretroviral treatment. N Engl J Med. 2006 ; 355(22):2283-2296.
5.
Walker S., Norwood J., Thornton C., Schaberg D.Trimethoprimsulfamethoxazole associated rhabdomyolysis in a patient with AIDS: case report and review of the literature. Am J Med Sci. 2006;331(6):339-341.
6.
Porras MC, Lecumberri JN, Castrillón JLTrimethoprim/sulfamethoxazole and metabolic acidosis in HIV-infected patients . Ann Pharmacother. 1998;32(2):185-189.
7.
Arnaudo E., Dalakas M., Shanske S., Moraes CT, DiMauro S., Schon EADepletion of muscle mitochondrial DNA in AIDS patients with zidovudine-induced myopathy. Lancet. 1991; 337(8740):508-510.
8.
Coghlan ME, Sommadossi JP, Jhala NC, Many WJ, Saag MS, Johnson VASymptomatic lactic acidosis in hospitalized antiretroviral-treated patients with human immunodeficiency virus infection: a report of 12 cases. Clin Infect Dis. 2001; 33(11):1914-1921.
9.
Schambelan M. , Benson C., Carr A., et al. Management of metabolic complications associated with antiretroviral therapy for HIV-1 infection: recommendations of an International AIDS Society-USA panel. J Acquir Immune Defic Syndr. 2002;31(3): 257-265.
10.
Boubaker K., Flepp M., Sudre H., Haensel A., Hirschel B., Boggian K.Hyperlactemia and antiretroviral therapy: the Swiss HIV cohort study. Clin Infect Dis. 2001;33(11):1931-1937.
11.
Mina J., Moore CB, James IR, et al. Chronic hyperlactatemia in HIV-infected patients taking antiretroviral therapy. AIDS. 2001; 15(6):717-723.
12.
Gerard Y., Maulin L., Yazdanpanah Y., et al. Symptomatic hyperlactataemia: an emerging complication of antiretroviral therapy. AIDS. 2000;14(17):2723-2730.
13.
Friedenberg AS , Brandoff DE, Schiffman FJType B lactic acidosis as a severe metabolic complication in lymphoma and leukemia: a case series from a single institution and literature review. Medicine. 2007;86(4):225-232.
14.
Caccamo D., Pervez NK, Marchevsky A.Primary lymphoma of the liver in the acquired immunodeficiency syndrome. Arch Pathol Lab Med. 1986;110(6):553-555.
15.
Bergin C., Pilkington R., McCreary F., Mulcahy F., Crowley V.Lactic acidosis, non-Hodgkins lymphoma and the acquired immunodeficiency syndrome . Genitourin Med. 1994;70(2):148-149.
16.
Rastogi MV, Desai N., Quintos JBNon-islet-cell tumor hypoglycemia and lactic acidosis in a child with congenital HIV and Burkitt’s lymphoma. J Pediatr Endocrinol Metab . 2008;21(8): 805-810.
17.
Zoufaly A., Stellbrink HJ, Heiden MA, et al. Cumulative HIV viremia during highly active antiretroviral therapy is a strong predictor of AIDS-related lymphoma. J Infect Dis.2009; 200(1):79-87.
18.
Cooper DJ, Walley KR, Wiggs BR, Russell JABicarbonate does not improve hemodynamics in critically ill patients who have lactic acidosis. Ann Intern Med. 1990;112(7):492-498.
19.
Fraley DS, Adler S., Bruns FJ, Zett B.Stimulation of lactate production by administration of bicarbonate in a patient with a solid neoplasm and lactic acidosis. N Engl J Med. 1980;303(19): 1100-1102.
20.
Barton IK, Streather CP, Hilton PJ, Bradley RDSuccessful treatment of severe lactic acidosis by haemofiltration using a bicarbonate-based replacement fluid. Nephrol Dial Transplant . 1991;6(5):368-370.
21.
Prikis M., Bhasin V., Young MP, Gennari J., Rimmer JMSustained low-efficiency dialysis as a treatment modality in a patient with lymphoma-associated lactic acidosis. Nephrol Dial Transplant . 2007;22(8):2383-2385.
