Fatal Lactic Acidosis Associated with Lymphoma, Interferon and Ribavirin§

Severe lactic acidosis in malignancies is a rare and fatal complication. We report a 51-yr male who presented with fever, fatigue and syncopal episodes and with past medical history of non-Hodgkin’s lymphoma in remission for 3 years, and hepatitis C. He developed severe lactic acidosis and eventually succumbed despite adequate and timely interventions. The clinical presentation resulting from the recurrence of non-Hodgkin’s lymphoma was evident from the initial dramatic response to steroid therapy and confirmed subsequently on histopathology. Mitochondrial toxicity from recent use of peg-interferon and ribavirin possibly contributed to the severity of lactic acidosis.