D-lactic acidosis – a rare complication of short bowel syndrome
Authors:
Vladimír Podušel 1; Simona Morgošová 1; Pavol Majdák 1; Jurina Sadloňová 2
Authors place of work:
Interné oddelenie, NsP Prievidza so sídlom v Bojniciach
1; I. interná klinika Jesseniovej lekárskej fakulty UK a Univerzitnej nemocnice v Martine
2
Published in the journal:
Vnitř Lék 2021; 67(E-5): 28-33
Category:
Case Report
Summary
D-lactic acidosis represents a rare form of metabolic acidosis that occurs most commonly in patients with short bowel syndrome. This is a serious, sometimes life-threatening complication. The cause is the accumulation of D-lactate in the body, which is formed in excessive amounts by fermentation of unabsorbed carbohydrates by the intestinal microbiota. The nervous system is predominantly affected, which also results in clinical manifestations. The clinical picture is dominated by a wide range of non-specific neurological symptoms. The disease can sometimes manifest as somnolence to coma. From the aspect of laboratory diagnostics, the disease is characterized by severe metabolic acidosis with an increased anion gap. In this case report, we present a unique case of a 54-year-old woman with Crohn’s disease and short bowel syndrome who in a short time was repeatedly hospitalized for recurrence of severe metabolic acidosis with severe impaired consciousness. Based on the evaluation of anamnestic data, clinical picture and laboratory tests, the patient was diagnosed with D-lactic acidosis. In the discussion we discuss the individual steps that led to this diagnosis and compare our experience with data in the world literature.
Keywords:
short bowel syndrome – D-lactic acidosis – encephalopathy
Zdroje
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Štítky
Diabetology Endocrinology Internal medicineČlánok vyšiel v časopise
Internal Medicine
2021 Číslo E-5
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