Severe Acidemia in a Patient with Waldenström Macroglobulinemia

Lactate is produced through the metabolism of glucose and subsequently eliminated by both the liver and the kidneys. Lactic acidosis develops when the rate of production of lactate overwhelms the body’s ability to clear it.1 There are 2 main types of L-lactic acidosis: A (ischemic) and B (nonischemic). Etiologies for type B lactic acidosis2 include: liver dysfunction, thiamine deficiency, malignancy, several drug associations, ketoacidosis, and mitochondrial disease (Table 1).3 Table 1 Etiologies of L-lactic acidosis