Fatal lactic acidosis due to leukemic transformation in a patient with non-Hodgkin's lymphoma: case report.

Lactic acidosis (LA) associated with hematologic malignancies is uncommon, lifethreatening, and generally occurs in adults. Its pathogenesis is poorly understood. This is a case report of LA due to leukemic transformation that occurred in a patient with non-Hodgkin’s lymphoma (NHL). A 24-year-old man with NHL was admitted to the hospital with dyspnea. Venous blood gas analysis revealed metabolic acidosis (pH 7.05; HCO3 6 mEq/L; BE 22 mmol/L; anion gap 28 mEq/L); the patient had an elevated plasma lactate concentration (12 mmol/L) and low glucose concentration (38 mg/dL). There was no reason other than leukemia—such as infection, circulatory failure, or drug use—for the development of severe LA. This case report shows that in patients with NHL, leukemic transformation may give rise to LA.