Warburg effect in B-cell lymphoma: A case report and proposed management plan

TL;DR

A case report describes a rare condition called the Warburg effect in a patient with B-cell lymphoma and suggests a management plan.

Contribution

A stepwise management approach is proposed for patients with suspected type B lactic acidosis.

Findings

A 70-year-old male with diffuse large B-cell lymphoma presented with severe metabolic derangements consistent with the Warburg effect.

Chemotherapy initiation led to initial clinical improvement despite hemodynamic instability.

Extensive investigations ruled out alternative causes of lactatemia and hypoglycemia.

Abstract

The Warburg effect is a rare but often fatal condition in patients with malignancies. This phenomenon, known as type B lactic acidosis, is defined by lactatemia without tissue hypoxia or hypoperfusion, in contrast to type A lactic acidosis, which usually results from either or both.

A male patient in his seventies with a newly diagnosed diffuse large B-cell lymphoma is admitted to the intensive care unit due to severe metabolic derangements with hypoglycemia and lactatemia. Extensive investigations ruled out alternative etiologies, strongly suggesting the Warburg effects as the underlying mechanism. Despite hemodynamic instability, chemotherapy was initiated and resulted in initial clinical improvement.

We propose a stepwise approach to improve the management of patients with suspected type B lactic acidosis.

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