Lactic Acidosis and Electrolyte Disturbances Associated With Hypertriglyceridemia in an Adolescent Receiving Chemotherapy for Acute Lymphoblastic Lymphoma

Given the association of lactic acidosis with inadequate tissue perfusion and poor clinical outcomes, an aggressive investigation and alterations in supportive and therapeutic care are needed for patients with lactic acidosis. However, other etiologies of lactic acidosis may exist, including disorders of excessive production or inadequate clearance. Several of these fall under the category known as "type B" lactic acidosis. We present a 17-year-old female with acute lymphoblastic leukemia who was admitted to the pediatric intensive care unit (PICU) for evaluation of lactic acidosis and severe hyponatremia. Subsequent evaluation argued against pathologic etiologies of lactic acidosis, leading to the conclusion that the high lactic acid laboratory value was caused by hypertriglyceridemia.