Authors: Marisa Brochado, Maria Margarida Pereira, Maria Inês Santos, Viktor Baiherych, Paula Cerqueira, Mafalda Sousa, Ivo Castro, Mariana Moniz Ramos, Marta Cerol, Petra Margarida Pego and Luís Siopa.
According to the Warburg Effect, or aerobic glycolysis, tumor cells prefer, in the presence of oxygen, to metabolize glucose through glycolysis, to the detriment of oxidative phosphorylation, producing high levels of lactate. This metabolic reprogramming, in which lactate is transported to the extracellular environment, promotes an acidic microenvironment, supporting the high rate of proliferation. The aerobic glycolytic phenomenon is present in several tumors, namely in hematological tumors such as Non- odgkin's Lymphoma (NHL).
The risk of developing NHL in the context of Human Immunodeficiency Virus (HIV) infection is approximately 60 to 100 times higher than that of the HIV-negative population.
This clinical case describes a patient hospitalized for a condition presumably compatible with gastrointestinal opportunistic infection, in an immunosuppressed patient with a recent diagnosis of HIV. It added, analytically, high hyperlactacidemia and marked hypoglycemia, not compatible with the clinical status of the patient, given that the patient was practically asymptomatic throughout the hospital stay.
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