Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Fabian, E; Kramer, L; Siebert, F; Högenauer, C; Raggam, RB; Wenzl, H; Krejs, GJ.
D-lactic acidosis - case report and review of the literature.
Z Gastroenterol. 2017; 55(1):75-82
Doi: 10.1055/s-0042-117647
(- Case Report)
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
- Fabian Elisabeth
- Krejs Günter Josef
- Co-Autor*innen der Med Uni Graz
- Hoegenauer Christoph
- Raggam Reinhard Bernd
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- Abstract:
- D-lactic acidosis is a rare complication that occurs mainly in patients with malabsorption due to a surgically altered gastrointestinal tract anatomy, namely in short bowel syndrome or after bariatric surgery. It is characterized by rapid development of neurological symptoms and severe metabolic acidosis, often with a high serum anion gap. Malabsorbed carbohydrates can be fermented by colonic microbiota capable of producing D-lactic acid. Routine clinical assessment of serum lactate covers only L-lactic acid; when clinical suspicion for D-lactic acidosis is high, special assays for D-lactic acid are called for. A serum level of more than 3 mmol/L of D-lactate confirms the diagnosis. Management includes correction of metabolic acidosis by intravenous bicarbonate, restriction of carbohydrates or fasting, and antibiotics to eliminate intestinal bacteria that produce D-lactic acid. We report a case of D-lactic acidosis in a patient with short bowel syndrome and review the pathophysiology of D-lactic acidosis with its biochemical and clinical features. D-lactic acidosis should be considered when patients with short bowel syndrome or other malabsorption syndromes due to an altered gastrointestinal tract anatomy present with metabolic acidosis and neurological symptoms that cannot be attributed to other causes. With the growing popularity of bariatric surgery, this metabolic derangement may be seen more frequently in the future. © Georg Thieme Verlag KG Stuttgart · New York.
- Find related publications in this database (using NLM MeSH Indexing)
- Acidosis, Lactic - diagnosis
- Acidosis, Lactic - etiology
- Acidosis, Lactic - therapy
- Anti-Bacterial Agents - administration & dosage
- Bicarbonates - administration & dosage
- Combined Modality Therapy - methods
- Diet Therapy - methods
- Female -
- Gastric Bypass - adverse effects
- Humans -
- Middle Aged -
- Short Bowel Syndrome - diagnosis
- Short Bowel Syndrome - etiology
- Short Bowel Syndrome - therapy
- Treatment Outcome -
- Find related publications in this database (Keywords)
- D-lactic acidosis
- metabolic acidosis
- short bowel syndrome
- bariatric surgery
- metabolic encephalopathy
- lactobacillus overgrowth