Non-Islet-Cell Tumor Hypoglycemia and Lactic Acidosis in a Child with Congenital HIV and Burkitt's Lymphoma

Non-islet-cell tumor hypoglycemia (NICTH) is a rare cause of hypoglycemia associated with tumors of mesenchymal, epithelial, or hematopoietic origin. Lactic acidosis is likewise an uncommon complication of hematological malignancy associated mainly with leukemia and lymphoma. Most cases of NICTH and lactic acidosis have been described in the adult population. We report a child with congenital HIV and AIDS who developed Burkitt's lymphoma, lactic acidosis and NICTH. An 11 year-old boy with AIDS, cerebral palsy and seizure disorder presented with intractable hypoglycemia 12 days after diagnosis of Burkitt's lymphoma. He had persistent hypoglycemia (serum glucose 20-40 mg/dl; 1.1-2.2 mmo/l) despite glucose infusion rate of 6 mg/kg/minute and trial of diazoxide treatment. Critical sample obtained at time of hypoglycemia showed insulin at 1.78 microU/ml (normal