Linfoma marginal del bazo asociado a acidosis láctica tipo B: Caso clínico

Vega, Jorge; Rodríguez, María de los Ángeles; Peña, A. Benito; Vásquez, Alejandro Arias

doi:10.4067/s0034-98872012000200014

Rev. méd. Chile

2012

DOI: 10.4067/s0034-98872012000200014

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Linfoma marginal del bazo asociado a acidosis láctica tipo B: Caso clínico

Jorge Vega

María de los Ángeles Rodríguez²,

A. Benito Peña

et al.

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Cited by 2 publications

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“…1,8 Vega et al 8 report the a 79-year-old splenectomized patient with relapsing SMZL, and type B lactic acidosis, who had an excellent response to rituximab monotherapy, improving blood cell counts and significantly decrease in lactate from the first dose of the antibody8. We reported a 62-yearold patient with 4 years of progressive increase in abdominal girth and heart failure.…”

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confidence: 99%

Radiotherapy or Anti CD 20 Antibodies as a First Treatment Line in Splenic Marginal Zone Lymphoma in Emergent Countries: The Experience in Chilean Population

C¹,

Ch²,

C³

et al. 2018

HPMIJ

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Abbreviations: SMZL, splenic marginal zone lymphoma; CVP, cyclophosphamide, vincristine and prednisone; CIT, chemo immuno therapy; SR, splenic radiotherapy OpinionSplenic marginal zone lymphoma (SMZL) is a rare malignant condition of B cells. It usually manifests with massive splenomegaly, and has frequent bone marrow and peripheral blood involvement.1 It amounts to 5% of non-Hodgkin's lymphomas and less than 1-2% of leukemias derived from low-grade lymphomas. SMZL, however, can be found in up to 25% of lymphomas diagnosed after a splenectomy. Its course is indolent, and its symptoms are vague and related to the discomfort caused by splenomegaly and cytopenia secondary to

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mentioning

confidence: 99%

Radiotherapy or Anti CD 20 Antibodies as a First Treatment Line in Splenic Marginal Zone Lymphoma in Emergent Countries: The Experience in Chilean Population

C¹,

Ch²,

C³

et al. 2018

HPMIJ

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A case of type B lactic acidosis as a complication of chronic myelomonocytic leukaemia: a case report and review of the literature

Gardner

Griffiths

2015

J Med Case Reports

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IntroductionType B lactic acidosis represents a rare and often lethal complication of haematological malignancy. Here, we present a patient who developed a type B lactic acidosis presumably due to a concurrent chronic myelomonocytic leukaemia. Upon swift initiation of cytoreductive chemotherapy (doxorubicin), the lactic acidosis was rapidly brought under control. This case adds to the literature reporting other haematological malignancies that can cause a type B lactic acidosis and its successful treatment.Case presentationWe report the case of a 77-year-old Caucasian man brought to our Accident and Emergency department following an unwitnessed collapse; he was found surrounded by coffee-ground vomit. Although haemodynamically stable on admission, he rapidly deteriorated as his lactic acid rose. An initial arterial blood gas revealed a pH of 7.27 and lactate of 18mmol/L (peaking at 21mmol/L).ConclusionsA high degree of clinical suspicion for haematological malignancy should be held when presented with a patient with lactic acidosis in clinical practice, even without evidence of poor oxygenation or another cause. Treatment with emergency chemotherapy, in lieu of a definitive diagnosis, was rapidly successful at lowering lactate levels within 8 hours. This may suggest a causal and perhaps direct relationship between lactic acid production and the presence of leukemic cells. Veno-venous haemofiltration had no apparent effect on reducing the lactic acidosis and therefore its benefit is questioned in this setting, especially at the cost of delaying chemotherapy. In the face of a life-threatening lactic acidosis, pragmatic clinical judgement alone may justify the rapid initiation of chemotherapy.

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Linfoma marginal del bazo asociado a acidosis láctica tipo B: Caso clínico

Cited by 2 publications

References 27 publications

Radiotherapy or Anti CD 20 Antibodies as a First Treatment Line in Splenic Marginal Zone Lymphoma in Emergent Countries: The Experience in Chilean Population

Radiotherapy or Anti CD 20 Antibodies as a First Treatment Line in Splenic Marginal Zone Lymphoma in Emergent Countries: The Experience in Chilean Population

A case of type B lactic acidosis as a complication of chronic myelomonocytic leukaemia: a case report and review of the literature

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