Lactic Acidosis in Prostate Cancer: Consider the Warburg Effect

Johannes C. van der Mijn, Mathijs J. Kuiper, Carl E.H. Siegert, Annabeth E. Wassenaar, Carel J.M. van Noesel, Aernout C. Ogilvie*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Lactic acidosis is a commonly observed clinical condition that is associated with a poor prognosis, especially in malignancies. We describe a case of an 81-year-old patient who presented with symptoms of tachypnea and general discomfort. Arterial blood gas analysis showed a high anion gap acidosis with a lactate level of 9.5 mmol/L with respiratory compensation. CT scanning showed no signs of pulmonary embolism or other causes of impaired tissue oxygenation. Despite treatment with sodium bicarbonate, the patient developed an adrenalin-resistant cardiac arrest, most likely caused by the acidosis. Autopsy revealed Gleason score 5 + 5 metastatic prostate cancer as the most probable cause of the lactic acidosis. Next-generation sequencing indicated a nonsense mutation in the TP53 gene (887delA) and an activating mutation in the PIK3CA gene (1634A>G) as candidate molecular drivers. This case demonstrates the prevalence and clinical relevance of metabolic reprogramming, frequently referred to as “the Warburg effect,” in patients with prostate cancer.

Original languageEnglish
Pages (from-to)1085-1091
Number of pages7
JournalCase Reports in Oncology
Issue number3
Publication statusPublished - 16 Nov 2017

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