To the Editor.
—In an article in the November 1978 Archives (138:1663-1664) by Spechler et al, they described two patients who had lactic acidosis in the setting of oat cell carcinoma of the lung with extensive hepatic metastases. I wish to report a similar case.
Report of a Case.
—A 79-year-old man was admitted to the hospital because of jaundice and weight loss. He was a heavy cigarette smoker and former alcoholic. Relatives denied that he had recently used alcohol or ingested any toxic substance. He took no medications. There was no history of heart disease, gastrointestinal or liver disease, seizures, uremia, or diabetes.On physical examination, his blood pressure was 110/60 mm Hg. The liver was smooth, firm, and 11 cm below the right costal margin. The spleen tip was not felt.Laboratory studies disclosed that the following values were either negative or normal: complete blood cells, prothrombin time,