Stimulation of Lactate Production by Administration of Bicarbonate in a Patient with a Solid Neoplasm and Lactic Acidosis

Abstract

LACTIC acidosis associated with acute leukemia has been attributed to overproduction of lactic acid by the tumor cells, ^{1 2 3} whereas lactic acidosis in solid, nonhematologic neoplasia with hepatic involvement is considered to be due to reduced hepatic use of lactate.⁴ Severe lactic acidosis is usually treated by administration of bicarbonate. This report describes a patient who had lactic acidosis and an anaplastic large-cell tumor involving the bone marrow. Bicarbonate therapy failed to improve the blood bicarbonate concentration in this patient, but, instead, increased lactic acid production. Reduced bicarbonate administration lowered lactic acid production and simplified his care.Case ReportAn 81-year-old . . .