We report the finding of a low venous bicarbonate and lactic acidosis in a patient with mild pancytopenia which raised the suspicion of haematological malignancy and expedited the diagnosis of acute lymphoblastic leukaemia. This report highlights the value of testing for lactic acidosis when haematological malignancies are considered and reviews the metabolism of lactic acidosis.
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Competing interests: none.
Patient consent: Patient/guardian consent was obtained for publication