Severe lactic acidosis and renal involvement in a patient with relapsed Burkitt's lymphoma

We describe an 8-year-old patient with relapsed Burkitt's lymphoma who developed complex metabolic problems, including renal diabetes insipidus and severe lactic acidosis. The lactic acidosis responded temporarily to chemo- and radiotherapy but not to bicarbonate or thiamine administration. These metabolic changes were most likely due to the lymphomatous infiltration of the kidneys. Severe lactic acidosis, without evidence of thiamine deficiency, seems to be a very rare event in children with cancer.