Abstract
D-Lactic acidemia is a rare and potentially lethal complication following massive small intestinal resection or intestinal bypass surgery. Reported is a 20-month-old child with short-bowel syndrome who developed recurrent episodes of atactic gait, slurred speech and somnolence associated with elevated serum levels of D-lactic acid. The pathophysiology of this condition is reviewed and its management discussed.
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References
Ayub A, Fallon WW, Haineg RF (1981) Encephalopathy following jejunoileostomy. JAMA 246: 970–973
Carr DB, Shih VE, Richter JM, Martin JB (1982) D-Lactic acidos simulating a hypothalamic syndrome after bowel bypass. Ann Neurol 11: 195–197
Haan E, Brown G, Bankiar A, Mitchell D, Hunt S, Blakey J, Barnes G (1985) Severe illness caused by the products of bacterial metabolism in a child with a short gut. Eur J Pediatr 144: 63–65
Karton M, Rettmer RL, Liptich EW (1987) Effect of parenteral nutrition and enteral feeding on D-Lactic acidosis in a patient with short bowel. J Parenter Enterol Nutr 11: 586–589
Oh MS, Phelps KR, Traube M, Barbosa Salvidar JL, Boxhill C, Caroll HJ (1979) D-Lactic acidosis in a man with the short bowel syndrome. N Engl J Med 301: 249–252
Oh MS, Uribarri J, Alverrangar D, Lazar I, Bazilinski N, Caroll HJ (1985) Metabolic utilization and renal handling of D-lactate in man. Metabolism 34: 621–625
Perlmutter DH, Boyle JT, Campos JM, Egler JM, Watkins JB (1983) D-Lactic acidosis in children: an unusual metabolic complication of small bowel resection. J Pediatr 102: 234–238
Ramakrishnan T, Stokes P (1985) Beneficial effects of fasting and low carbohydrate diet in D-lactic acidosis associated with short bowel syndrome. J Parent Enterol Nutr 9: 361–363
Reynolds AF, Villar HV, Kasmiak AW (1981) Jejunoileal bypass: a reversible cause of dementia. Neurosurgery 9: 153–156
Satoh T, Narisawa K, Katoh T, Fujiyoma J, Tomoe A, Metoki K, Hayasaka K, Tada K, Ishibashi M, Yamane N, Mituoka T, Benno Y (1982) D-Lactic acidosis in two patients with short bowel syndrome: bacteriological analyses of the fecal flora. Eur J Pediatr 138: 324–326
Schoorel EP, Giesberto MAH, Van Gelderen HH (1980) D-Lactic acidosis in a boy with short bowel syndrome. Arch Dis Child 55: 810–812
Scully TB, Kraft SC, Carr WC, Harig JM (1989) D-Lactate assoc encephalopathy after massive small bowel resection. J Clin Gastroenterol 11: 448–451
Silverman A, Roy CC (eds) (1983) Pediatric clinical gastroenterology, 3rd edn. Mosby, St. Louis Toronto London, pp 215
Stolberg L, Rolfe R, Gitlin N, Merritt J, Mann L, Linder J, Finegold S (1982) D-Lactic acidosis due to abnormal gut flora. N Engl J Med 306: 1344–1348
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Granot, E., Abu-Dalu, K. & Schiller, M. D-Lactic acidosis, a life-threatening complication in short-bowel syndrome. Pediatr Surg Int 7, 234–235 (1992). https://doi.org/10.1007/BF00175852
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DOI: https://doi.org/10.1007/BF00175852