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53-years-old with mental status changes

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Comprehensive Therapy

Abstract

D-lactic acidosis, a complication of short bowel syndrome, presents with a variety of neurological symptoms and metabolic acidosis. Treatment is hydration, replacement of nutritional deficiency replacement, and selective antibiotics. Prevention entails complex carbohydrate diet and vitamin and mineral supplements.

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References

  1. Hudson M., Pocknee R., Mowat NA. D-lactic acidosis in short bowel syndrome. An examination of possible mechanisms. Q J Med. 1990;74:157–63.

    PubMed  CAS  Google Scholar 

  2. Hove H, Mortensen B. Colonic lactate metabolism and D-lactic acidosis. Digest Dis Sci. 1995;40:320–30.

    Article  PubMed  CAS  Google Scholar 

  3. Cross SA, Callaway W. D-lactic acidosis and selected cerebellar ataxias. Mayo Clin Proc. 1984;59:202–5.

    PubMed  CAS  Google Scholar 

  4. Kadakia SC. D-lactic acidosis in a patient with jejunoileal bypass. J Clin Gastroenterol. 1995;20:154–6.

    Article  PubMed  CAS  Google Scholar 

  5. Coronado BE, Opal SM, Yoburn D. Antibiotic induced D-lactic acidosis. Ann Intern Med. 1995;122:839–42.

    PubMed  CAS  Google Scholar 

  6. Oh MS, Uribarri J, Alveranga D, Lazar I, Bazilinski N, Carol HI. Metabolic utilization and renal handling of D lactate in men. Metabolism. 1985;34:621–5.

    Article  PubMed  CAS  Google Scholar 

  7. De Vrese M, Koppenhoefer B, Barht CA. D-lactic acid metabolism after and oral load of D-lactate. Clin Nutrition. 1990;9:23–8.

    Google Scholar 

  8. Vella A, Farrugia G, D-lactic acidosis: Pathologic consequence of saprophytism. Mayo Clin Proc. 1998;73:451–6.

    Article  PubMed  CAS  Google Scholar 

  9. Halperin ML, Kamel KS. D-lactic acidosis: Turning sugar into acids in the gastrointestinal tract. Kidney Int. 1996;49:1–8.

    PubMed  CAS  Google Scholar 

  10. Bongaerts G, Tolboom J, Naber T, Bakkeren J, Severijnen R, Willems H. D-lactic acidemia and aciduria in pediatric and adult patients with short bowel syndrome. Clin Chem. 1995; 41:107–10.

    PubMed  CAS  Google Scholar 

  11. Gurevitch J, Sela B, Jonas A, Golan H, Yahav Y, Passwell JH. D-lactic acidosis: A treatable encephalopathy in pediatric patients. Acta Pediatrica. 1993;82:119–21.

    CAS  Google Scholar 

  12. Oh MS, Phelps KR, Traube M, Barbosa-Saldivar M, Boxhill C, Carrol H. D-lactic acidosis in a man with the short bowel syndrome. N Engl J Med. 1979;301:249–52.

    Article  PubMed  CAS  Google Scholar 

  13. Jover R, Leon J, Palazon JM, Dominguez JR. D-lactic acidosis associated with use of medium-chain triglycerides. Lancet. 1995;346:314.

    Article  PubMed  CAS  Google Scholar 

  14. Day AS, Abbott GD. D-lactic acidosis in short bowel syndrome. NZ Med J. 1999;112:277–8.

    CAS  Google Scholar 

  15. Stoberg L, Rolfe R, Gitlin N, et al. D-lactic acidosis due to abnormal gut flora. N Engl J Med. 1982;306:1344–8.

    Article  Google Scholar 

  16. Ramakrishnan T, Stokes P. Beneficial effects of fasting and low carbohydrate diet in D lactic acidosis associated with short bowel syndrome. J Parent Enteral Nutrition. 1985;9:361–363.

    CAS  Google Scholar 

  17. Perlmutter D, Boyle J, Campos J, Egler J, Watkins J. D-lactic acidosis in children: An unusual metabolic complication of small bowel resection. J Pediatr. 1983;102:234–8.

    Article  PubMed  CAS  Google Scholar 

  18. Carr D, Shih V, Richter J, Martin J. D-lactic acidosis simulating a hypothalamic syndrome after bowel bypass. Ann Neurol. 1982;11:159–7.

    Article  Google Scholar 

  19. Narula RK, El Shafei A, Ramaihia D, Schmitz PG. D-lactic acidosis 23 years after jejuno-ileal bypass. Am J Kidney Dis 2000;36:E9.

    PubMed  CAS  Google Scholar 

  20. Karton M, Rettmer R, Lipkin E. Effects of parenteral and enteral feeding on D-lactic acidosis in a patient with short bowel. J Parent Enteral Nutrition. 1987;11:586–9.

    CAS  Google Scholar 

  21. Reynold SF, Blass JP. A possible mechanism for selective cerebellar damage in partial pyruvate dehydrogenase deficiency. Neurology. 1976;26:625–8.

    Google Scholar 

  22. Bongaerts G, Tolboom J, Naber T, Bakkeraen J, Severijnen R, Willems H. D-lactic acidosis in patients with short bowel syndrome. Clin Chem. 1995;41:768–9.

    CAS  Google Scholar 

  23. Spillane K, Nagendran K, Prior PF, Tabaqchali S, Wilks M. Serial electroencephalograms in a patient with D-lactic acidosis. Electroencephalogr Clin Neurophysiol. 1994;91:403–5.

    Article  PubMed  CAS  Google Scholar 

  24. Mayne AJ, Handy DJ, Preece MA, George RH, Booth JW. Dietary management of D-lactic acidosis in short bowel syndrome. Arch Diseases Child. 1990;65:229–31.

    CAS  Google Scholar 

  25. Hingorani AD, Macdougall IC, Browne M, Walker RW, Tomson CR. Successful treatment of acute D-lactate encephalopathy by hemodialysis. Nephrol Dial Trasplant. 1993;8:1283–5.

    CAS  Google Scholar 

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Authors and Affiliations

  1. Internal Medicine Residency Program/NA21, Cleveland Clinic Foundation, Cleveland, Ohio

    M. Obadahal Chekakie MD & M. Luayal Kotoub MD

  2. Department of General Internal Medicine/E13, Cleveland Clinic Foundation, 9500 Euclid Avenue, 44195, Cleveland, OH, USA

    Craig Nielsen MD

Authors
  1. M. Obadahal Chekakie MD
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  2. M. Luayal Kotoub MD
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  3. Craig Nielsen MD
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The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.

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Chekakie, M.O., Kotoub, M.L. & Nielsen, C. 53-years-old with mental status changes. Compr Ther 30, 87–92 (2004). https://doi.org/10.1007/s12019-004-0002-6

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  • DOI: https://doi.org/10.1007/s12019-004-0002-6

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