Saudi Journal of Kidney Diseases and Transplantation

: 2014  |  Volume : 25  |  Issue : 6  |  Page : 1270--1277

Warburg俟Q製 effect on solid tumors

Talal El Imad, Lara El Khoury, Abdallah Sassine Geara 
 Lebanese University, Beirut, Lebanon

Correspondence Address:
Dr. Abdallah Sassine Geara
Nephrology Department, West Virginia University, 527 medical Park drive, Bridgeport, WV, 26330

Lactic acidosis is the result of imbalance between the systemic formation of lactate and its hepatic metabolism. In cancer patients, lactic acidosis is mainly associated with hematologic malignancies (leukemia and lymphomas) and the mechanism is known as Warburg俟Q製 effect. We report a 76-year-old male known to have hypertension and coronary artery disease, who presented with abdominal distension and lactic acidosis. His initial evaluation showed multiple liver masses that were biopsied and the patient was diagnosed with undifferentiated carcinoma of unknown primary, involving the liver. The patient had progression of lactic acidosis leading to his death on day-15. As the lactic acidosis was not in the setting of hypoxia or hemodynamic instability, we made the diagnosis of malignancy-associated type B lactic acidosis, also known as the Warburg俟Q製 effect. Warburg俟Q製 effect can occur in solid cancer if the tumor involves the liver. It has bad prognostic implications. The use of intravenous bicarbonate as a temporary measure is of controversial benefit, as it can potentially worsen the metabolic acidosis and its use should be limited to patients with very low pH. In cancer patients, the use of lactatebased intravenous fluids can be potentially harmful and can increase the risk of tumor metastasis, at least in animal malignancy models.

How to cite this article:
El Imad T, El Khoury L, Geara AS. Warburg's effect on solid tumors.Saudi J Kidney Dis Transpl 2014;25:1270-1277

How to cite this URL:
El Imad T, El Khoury L, Geara AS. Warburg's effect on solid tumors. Saudi J Kidney Dis Transpl [serial online] 2014 [cited 2022 May 27 ];25:1270-1277
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