{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:59:48Z","timestamp":1792094388363,"version":"4.4.0"},"reference-count":11,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,3,3]]},"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:p>Lactic acidosis (LA) is characterised by persistently increased blood lactate &gt;5\u2009mmol\/L. Type A LA due to anaerobic glycolysis is frequently seen during management of haematological malignancies. A rare form of LA known as type B LA, which occurs as a result of metabolic dysregulation at cellular level has been described recently. This has been reported to be because of Warburg effect (WE) or aerobic glycolysis, which is seen in cancerous cells as they rely on aerobic glycolysis rather than oxidative phosphorylation for energy generation. Presence of type B LA at initial presentation of haematological malignancies is a poor prognosticating factor and has rarely been reported in children. We present a child with T cell acute lymphoblastic leukaemia with mild phenotype of type B LA due to WE. She responded dramatically to definitive chemotherapy and tolerated intensive phase of chemotherapy without any significant morbidity.<\/jats:p>","DOI":"10.1136\/bcr-2019-233941","type":"journal-article","created":{"date-parts":[[2020,3,18]],"date-time":"2020-03-18T08:59:40Z","timestamp":1584521980000},"page":"e233941","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Type B lactic acidosis due to Warburg effect in a child presenting with T cell acute lymphoblastic leukaemia: a milder phenotype"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4754-8340","authenticated-orcid":false,"given":"Sanjeev","family":"Khera","sequence":"first","affiliation":[{"name":"Pediatrics, Army Hospital Research and Referral, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suman Kumar","family":"Pramanik","sequence":"additional","affiliation":[{"name":"Hematology, Army Hospital Research & Referral, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2558-0518","authenticated-orcid":false,"given":"Suprita","family":"Kalra","sequence":"additional","affiliation":[{"name":"Pediatrics, Army Hospital Research and Referral, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aradhana","family":"Dwivedi","sequence":"additional","affiliation":[{"name":"Pediatrics, Army Hospital Research and Referral, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,3,17]]},"reference":[{"key":"2025082712111778000_13.3.e233941.1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20011101)92:9<2237::AID-CNCR1569>3.0.CO;2-9"},{"key":"2025082712111778000_13.3.e233941.2","doi-asserted-by":"publisher","DOI":"10.1126\/science.1160809"},{"key":"2025082712111778000_13.3.e233941.3","first-page":"347","article-title":"Early recognition of malignant lactic acidosis in clinical practice: report on 6 patients with haematological malignancies","volume":"67","author":"De Raes","year":"2012","journal-title":"Acta Clin Belg"},{"key":"2025082712111778000_13.3.e233941.4","doi-asserted-by":"publisher","DOI":"10.7150\/jca.14274"},{"key":"2025082712111778000_13.3.e233941.5","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199006000-00018"},{"key":"2025082712111778000_13.3.e233941.6","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1053\/j.ajkd.2016.04.020","article-title":"Lactic acidosis: current treatments and future directions","volume":"68","author":"Kraut","year":"2016","journal-title":"Am J Kidney Dis"},{"key":"2025082712111778000_13.3.e233941.7","first-page":"69","article-title":"B-Cell lymphoma, thiamine deficiency, and lactic acidosis","volume":"30","author":"Masood","year":"2017","journal-title":"Proc"},{"key":"2025082712111778000_13.3.e233941.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2004.05094.x"},{"key":"2025082712111778000_13.3.e233941.9","doi-asserted-by":"publisher","DOI":"10.1023\/A:1022490512705"},{"key":"2025082712111778000_13.3.e233941.10","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2018.00232","article-title":"The Warburg effect as a type B lactic acidosis in a patient with acute myeloid leukemia: a diagnostic challenge for clinicians","volume":"8","author":"Brault","year":"2018","journal-title":"Front Oncol"},{"key":"2025082712111778000_13.3.e233941.11","first-page":"1","article-title":"Severe metabolic acidemia in a patient with Aleukemic leukemia","volume":"2018","author":"Ghrewati","year":"2018","journal-title":"Case Rep Nephrol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-233941","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:11:26Z","timestamp":1756321886000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-233941"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3]]},"references-count":11,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,3,17]]},"published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1136\/bcr-2019-233941"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-233941","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3]]}}}