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Case Reports in Transplantation
Volume 2017 (2017), Article ID 3704309, 4 pages
https://doi.org/10.1155/2017/3704309
Case Report

Unusual Case of Severe Lactic Acidosis in a Liver Transplant Patient

1Department of Anesthesiology, Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, PA, USA
2Department of Surgery, Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, PA, USA

Correspondence should be addressed to Michael S. Green

Received 1 September 2017; Revised 30 October 2017; Accepted 3 December 2017; Published 17 December 2017

Academic Editor: Ryszard Grenda

Copyright © 2017 Shweta Yemul Golhar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Lactic acidosis is a standard indicator for oxygen debt and some other very significant causes. We describe a case of liver transplant patient presenting with vague abdominal pain and lactic acidosis without any liver dysfunction/failure/ischemia/rejection or sepsis. The imaging studies showed vague bowel edema and normal hepatic perfusion. The patient continued to deteriorate with rising lactic acidosis when a repeat CT abdomen eventually showed signs of lymphomatosis peritonei. Biopsy revealed the unusual diagnosis of posttransplant lymphoproliferative disorder. Immediate discontinuation of immunosuppression and initiation of chemotherapy led to clinical improvement. Our intention of presenting this case is to increase awareness of posttransplant lymphoma and propose lactic acidosis as not only an indicator of liver dysfunction or rejection but also an aid for diagnosis of this unusual but fatal and potentially curable condition.