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Pediatric Nephrology
Erschienen in: Pediatric Nephrology 4/2018

07.12.2017 | Original Article

D-lactic acidosis in humans: systematic literature review

verfasst von: Davide G. A. M. Bianchetti, Giacomo S. Amelio, Sebastiano A. G. Lava, Mario G. Bianchetti, Giacomo D. Simonetti, Carlo Agostoni, Emilio F. Fossali, Gregorio P. Milani

Erschienen in: Pediatric Nephrology | Ausgabe 4/2018

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Abstract

Background

D-lactic acidosis is an uncommon and challenging form of metabolic acidosis that may develop in short bowel syndrome. It has been documented exclusively in case reports and small case series.

Methods

We performed a review of the literature in the National Library of Medicine and Excerpta Medica databases.

Results

We identified 84 original reports published between 1977 and 2017. D-lactic acidosis was observed in 98 individuals ranging in age from 7 months to 86 years with short bowel syndrome. The clinical presentation included Kussmaul breathing, confusion, slurred speech, and gait disturbances. Furthermore, among 99 consecutive patients with short bowel syndrome, 21 reported having episodes with symptoms consistent with D-lactic acidosis. In addition, D-lactic acid might also contribute to acidosis in diabetes mellitus. Finally, abnormally high D-lactic acid was documented after administration or ingestion of large amounts of propylene glycol, as paraneoplastic phenomenon and perhaps also in a so far poorly characterized inherited inborn error of metabolism.

Conclusions

In humans with short bowel syndrome (or carbohydrate malabsorption), D-lactic acidosis is likely rather common and under-recognized. This condition should be included in the differential diagnosis of unexplained high-gap metabolic acidosis where the anion causing the acidosis is not known. Furthermore, diabetic acidosis might be caused by accumulation of both ketone bodies and D-lactic acid. Finally, there are endogenous sources of D-lactic acid in subjects with propylene glycol intoxication.
Literatur
1.
Halperin ML, Kamel KS (1996) D-lactic acidosis: turning sugar into acids in the gastrointestinal tract. Kidney Int 49:1–8CrossRefPubMed
2.
Adeva-Andany M, López-Ojén M, Funcasta-Calderón R, Ameneiros-Rodríguez E, Donapetry-García C, Vila-Altesor M, Rodríguez-Seijas J (2014) Comprehensive review on lactate metabolism in human health. Mitochondrion 7:76–100CrossRef
3.
Oh MS, Uribarri J, Carroll HJ (1988) Electrolyte case vignette: a case of unusual organic acidosis. Am J Kidney Dis 11:80–82CrossRefPubMed
4.
Uribarri J, Oh MS, Carroll HJ (1998) D-lactic acidosis. A review of clinical presentation, biochemical features, and pathophysiologic mechanisms. Medicine (Baltimore) 77:73–82CrossRef
5.
Oh MS, Phelps KR, Traube M, Barbosa-Saldivar JL, Boxhill C, Carroll HJ (1979) D-lactic acidosis in a man with the short-bowel syndrome. N Engl J Med 301:249–252CrossRefPubMed
6.
Fuller TJ, Garg LC, Harty RF, Cerda JJ, O'Leary JP (1978) Severe hyperchloremic acidosis complicating jejunoileal bypass. Surg Gynecol Obstet 146:567–571PubMed
7.
8.
Ayub A, Faloon WW, Heinig RE (1981) Encephalopathy following jejunoileostomy. JAMA 246:970–973CrossRefPubMed
9.
Reynolds AF, Villar HV, Kasniak AW (1981) Jejunoileal bypass: a reversible cause of dementia. Neurosurgery 9:153–156CrossRefPubMed
10.
11.
Carr DB, Shih VE, Richter JM, Martin JB (1982) D-lactic acidosis simulating a hypothalamic syndrome after bowel bypass. Ann Neurol 11:195–197CrossRefPubMed
12.
Carr DB, Shih VE, Richter JM, Martin JB (1982) Encephalopathy following jejunoileostomy. JAMA 247:1127CrossRefPubMed
13.
Finestone AJ, Chodhury AR (1982) Encephalopathy following jejunoileostomy. JAMA 247:1938–1939CrossRefPubMed
14.
McCabe ER, Goodman SI, Fennessey PV, Miles BS, Wall M, Silverman A (1982) Glutaric, 3-hydroxypropionic, and lactic aciduria with metabolic acidemia, following extensive small bowel resection. Biochem Med 28:229–236CrossRefPubMed
15.
Satoh T, Narisawa K, Konno T, Katoh T, Fujiyama J, Tomoe A, Metoki K, Hayasaka K, Tada K, Ishibashi M, Yamane N, Mitsuoka T, Benno Y (1982) D-lactic acidosis in two patients with short bowel syndrome: bacteriological analyses of the fecal flora. Eur J Pediatr 138:324–326CrossRefPubMed
16.
Stolberg L, Rolfe R, Gitlin N, Merritt J, Mann L Jr, Linder J, Finegold S (1982) D-lactic acidosis due to abnormal gut flora: diagnosis and treatment of two cases. N Engl J Med 306:1344–1348CrossRefPubMed
17.
Traube M, Bock J, Boyer JL (1982) D-lactic acidosis after jejunoileal bypass. N Engl J Med 307:1027PubMed
18.
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 102:234–238CrossRefPubMed
19.
Traube M, Bock JL, Boyer JL (1983) D-lactic acidosis after jejunoileal bypass: identification of organic anions by nuclear magnetic resonance spectroscopy. Ann Intern Med 98:171–173CrossRefPubMed
20.
Dahlquist NR, Perrault J, Callaway CW, Jones JD (1984) D-lactic acidosis and encephalopathy after jejunoileostomy: response to overfeeding and to fasting in humans. Mayo Clin Proc 59:141–145CrossRefPubMed
21.
Halverson J, Gale A, Lazarus C (1984) D-lactic acidosis and other complications of intestinal bypass surgery. Arch Intern Med 144:357–360CrossRefPubMed
22.
McNeil A, Walmsley RN (1984) A case of combined D-lactate and renal tubular acidosis. Clin Chem 30:1722PubMed
23.
Haan E, Brown G, Bankier 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 144:63–65CrossRefPubMed
24.
Ramakrishnan T, Stokes P (1985) Beneficial effects of fasting and low carbohydrate diet in D-lactic acidosis associated with short-bowel syndrome. JPEN J Parenter Enteral Nutr 9:361–363CrossRefPubMed
25.
Rosenthal P, Pesce M (1985) Long-term monitoring of D-lactic acidosis in a child. J Pediatr Gastroenterol Nutr 4:674–676CrossRefPubMed
26.
Mason PD (1986) Metabolic acidosis due to D-lactate. Br Med J (Clin Res Ed) 292:1105–1106CrossRef
27.
Karton M, Rettmer RL, Lipkin EW (1987) Effect of parenteral nutrition and enteral feeding on D-lactic acidosis in a patient with short bowel. JPEN J Parenter Enteral Nutr 11:586–589CrossRefPubMed
28.
Scully TB, Kraft SC, Carr WC, Harig JM (1989) D-lactate-associated encephalopathy after massive small-bowel resection. J Clin Gastroenterol 11:448–451CrossRefPubMed
29.
Flourie B, Messing B, Bismuth E, Etanchaud F, Thuillier F, Rambaud JC (1990) Acidose D lactique et encéphalopathie au cours d’un syndrome du grêle court à l’occasion d’un traitement antibiotique. Gastroenterol Clin Biol 14:596–598PubMed
30.
Mayne AJ, Handy DJ, Preece MA, George RH, Booth IW (1990) Dietary management of D-lactic acidosis in short bowel syndrome. Arch Dis Child 65:229–231CrossRefPubMedPubMedCentral
31.
Hudson M, Pocknee R, Mowat NA (1990) D-lactic acidosis in short bowel syndrome - an examination of possible mechanisms. Q J Med 74:157–163PubMed
32.
Forsyth RJ, Moulden A, Hull D (1991) D-lactate associated encephalopathy in short bowel syndrome: management with long-term non-absorbable oral antimicrobials. Clin Nutr 10:352–355CrossRefPubMed
33.
Gurevitch J, Sela B, Jonas A, Golan H, Yahav Y, Passwell JH (1993) D-lactic acidosis: a treatable encephalopathy in pediatric patients. Acta Paediatr 82:119–121CrossRefPubMed
34.
Hingorani AD, Macdougall IC, Browne M, Walker RW, Tomson CR (1993) Successful treatment of acute D-lactate encephalopathy by haemodialysis. Nephrol Dial Transplant 8:1283–1285PubMed
35.
Koletzko S, Waag KL, Koletzko B (1994) Rezidivierende D-Lactat-Acidosen mit Enzephalopathie bei einem Jungen mit Kurzdarmsyndrom. Dtsch Med Wochenschr 119:458–462CrossRefPubMed
36.
Spillane K, Nagendran K, Prior PF, Tabaqchali S, Wilks M (1994) Serial electroencephalograms in a patient with D-lactic acidosis. Electroencephalogr Clin Neurophysiol 91:403–405CrossRefPubMed
37.
Bongaerts G, Tolboom J, Naber T, Bakkeren J, Severijnen R, Willems H (1995) D-lactic acidemia and aciduria in pediatric and adult patients with short bowel syndrome. Clin Chem 41:107–110PubMed
38.
Coronado BE, Opal SM, Yoburn DC (1995) Antibiotic-induced D-lactic acidosis. Ann Intern Med 122:839–842CrossRefPubMed
39.
Jover R, León J, Palazón JM, Domínguez JR (1995) D-lactic acidosis associated with use of medium-chain triglycerides. Lancet 346:314CrossRefPubMed
40.
Kadakia SC (1995) D-lactic acidosis in a patient with jejunoileal bypass. J Clin Gastroenterol 20:154–156CrossRefPubMed
41.
Vella A, Farrugia G (1998) D-lactic acidosis: pathologic consequence of saprophytism. Mayo Clin Proc 3:451–456CrossRef
42.
Day AS, Abbott GD (1999) D-lactic acidosis in short bowel syndrome. N Z Med J 112:277–278PubMed
43.
Godey F, Bouasria A, Ropert M, Diakite M, Le Treut A, Balençon M (2000) Don’t forget to test for D-lactic acid in short bowel syndrome. Am J Gastroenterol 95:3675–3677CrossRefPubMed
44.
Narula RK, El Shafei A, Ramaiah D, Schmitz PG (2000) D-lactic acidosis 23 years after jejuno-ileal bypass. Am J Kidney Dis 36:E9CrossRefPubMed
45.
Gavazzi C, Stacchiotti S, Cavalletti R, Lodi R (2001) Confusion after antibiotics. Lancet 357:1410CrossRefPubMed
46.
Lalive PH, Hadengue A, Mensi N, Burkhard PR (2001) Encéphalopathie complexe, transitoire et récidivante après résection étendue de l'intestin grêle. Responsabilité du D-Lactate. Rev Neurol (Paris) 157:679–681
47.
Angelet P, Compte MT, Cid JL, Soriano T, Vilaseca J, Bartolomé J (2000) Episodios recurrentes de acidosis con encefalopatía en un paciente en programa de hemodiálisis con síndrome del intestino corto. Nefrología 22:196–198
48.
Azhar SS, Beach RE (2002) D-lactic acidosis in a diabetic patient with a short bowel. J Am Board Fam Pract 15:316–318PubMed
49.
Kamar M, Raziel A, Susmallian S, Kyzer S, Charuzi I (2003) D-lactic acidosis in a patient after subtotal colectomy. Isr Med Assoc J 5:891–892PubMed
50.
51.
Al Chekakie MO, Al Kotoub ML, Nielsen C (2004) 53-years-old with mental status changes. Compr Ther 30:87–92CrossRefPubMed
52.
Uchida H, Yamamoto H, Kisaki Y, Fujino J, Ishimaru Y, Ikeda H (2004) D-lactic acidosis in short-bowel syndrome managed with antibiotics and probiotics. J Pediatr Surg 39:634–636CrossRefPubMed
53.
Bongaerts G, Severijnen R, Skladal D, Bakkeren J, Sperl W (2005) Yeast mediates lactic acidosis suppression after antibiotic cocktail treatment in short small bowel? Scand J Gastroenterol 40:1246–1250CrossRefPubMed
54.
Puwanant M, Mo-Suwan L, Patrapinyokul S (2005) Recurrent D-lactic acidosis in a child with short bowel syndrome. Asia Pac J Clin Nutr 14:195–198PubMed
55.
Ku WH, Lau DCY, Huen KF (2006) Probiotics provoked D-lactic acidosis in short bowel syndrome: case report and literature review. Hong Kong J Paediatr 11:246–254
56.
Modi BP, Langer M, Duggan C, Kim HB, Jaksic T (2006) Serial transverse enteroplasty for management of refractory D-lactic acidosis in short-bowel syndrome. J Pediatr Gastroenterol Nutr 43:395–397CrossRefPubMedPubMedCentral
57.
Soler Palacín P, Garzón Lorenzo P, Castilla Fernández Y, Arranz Amo JA, Scheider S, Tormo Carnicé R, del Toro RM, Figueras Nadal C (2006) Acidosis D-láctica en un paciente de 11 años con síndrome de intestino corto. An Pediatr (Barc) 64:385–387CrossRef
58.
Dahhak S, Uhlen S, Mention K, Romond MB, Fontaine M, Gottrand F, Turck D, Michaud L (2008) Acidose d-lactique chez un enfant présentant un syndrome de grêle court. Arch Pédiatr 15:145–148CrossRefPubMed
59.
60.
Arancibia AG, Hodgson MBI, Paul HDR (2010) D-lactoacidosis como complicación del síndrome de intestino corto. Rev Chil Pediatr 81:353–357CrossRef
61.
Chang YM, Chiew YW, Yang CS (2010) The case: a woman with severe metabolic acidosis. Kidney Int 77:261–262CrossRefPubMed
62.
63.
Munakata S, Arakawa C, Kohira R, Fujita Y, Fuchigami T, Mugishima H (2010) A case of D-lactic acid encephalopathy associated with use of probiotics. Brain and Development 32:691–694CrossRefPubMed
64.
Tapia Guerrero MJ, Olveira G, Bravo Utrera M, Colomo Rodríguez N, Fernández García JC (2010) Ácidosis D-láctica secundaria a síndrome de intestino corto. Nutr Hosp 25:864–866PubMed
65.
Htyte N, White L, Sandhu G, Jones J, Meisels I (2011) An extreme and life-threatening case of recurrent D-lactate encephalopathy. Nephrol Dial Transplant 26:1432–1435CrossRefPubMed
66.
Gigante A, Sardo L, Gasperini ML, Molinaro A, Riggio O, Laviano A, Amoroso A (2012) D-lactic acidosis 25 years after bariatric surgery due to Salmonella enteritidis. Nutrition 28:108–111CrossRefPubMed
67.
Burski CM, Miller CS, Centor RM (2013) Formerly obese, now thin and confused: the utility of mnemonics in the approach to altered mental status. Am J Med Sci 346:499–502CrossRefPubMed
68.
Dahlqvist G, Guillen-Anaya MA, Vincent MF, Thissen JP, Hainaut P (2013) D-lactic acidosis: an unusual cause of encephalopathy in a patient with short bowel syndrome. Acta Clin Belg 68:229–231CrossRefPubMed
69.
Singh PM, Borle A, Trikha A (2013) Diagnostic dilemma: rare case of recurrent d-lactic acidosis leading to recurrent acute cardiac failure. Acta Anaesthesiol Taiwanica 51:94–96CrossRef
70.
Takahashi K, Terashima H, Kohno K, Ohkohchi N (2013) A stand-alone synbiotic treatment for the prevention of D-lactic acidosis in short bowel syndrome. Int Surg 98:110–113CrossRefPubMedPubMedCentral
71.
Park B, Fichadia U, Shah A (2015) A 3-year-old boy with ataxia. Pediatr Emerg Care 31:220–221CrossRefPubMed
72.
Obando Pacheco P, Navas López VM, Yahyaoui Macías R, Sierra Salinas C (2016) Acidosis D-láctica en un niño de 10 meses afecto de un síndrome de intestino corto: la rápida sospecha equivale a un rápido tratamiento. An Pediatr (Barc) 84:56–57CrossRef
73.
Planas-Vilaseca A, Guerrero-Pérez F, Marengo AP, Lopez-Urdiales R, Virgili-Casas N (2016) D-lactic acidosis: a rare cause of metabolic acidosis. Endocrinol Nutr 63:433–434CrossRefPubMed
74.
Fabian E, Kramer L, Siebert F, Högenauer C, Raggam RB, Wenzl H, Krejs GJ (2017) D-lactic acidosis - case report and review of the literature. Z Gastroenterol 55:75–82PubMed
75.
Davidovics ZH, Vance K, Etienne N, Hyams JS (2017) Fecal transplantation successfully treats recurrent D-lactic acidosis in a child with short bowel syndrome. JPEN J Parenter Enteral Nutr 41:896–897CrossRefPubMed
76.
77.
Thurn JR, Pierpont GL, Ludvigsen CW, Eckfeldt JH (1985) D-lactate encephalopathy. Am J Med 79:717–721CrossRefPubMed
78.
Hosie S, Loff S, Wirth H, Rapp HJ, von Buch C, Waag KL (2006) Experience of 49 longitudinal intestinal lengthening procedures for short bowel syndrome. Eur J Pediatr Surg 16:171–175CrossRefPubMed
79.
80.
Grünert S, Schmidts M, Kenzel S, Sass JO, Greiner P, Pohl M, Hentschel R (2010) D-lactic acidosis: “right-left disorientation” in laboratory testing: acute encephalopathy in a child with carbohydrate malabsorption syndrome. J Pediatr Gastroenterol Nutr 50:106–107PubMed
81.
Lu J, Zello GA, Randell E, Adeli K, Krahn J, Meng QH (2011) Closing the anion gap: contribution of D-lactate to diabetic ketoacidosis. Clin Chim Acta 412:286–291CrossRefPubMed
82.
Bo J, Li W, Chen Z, Wadden DG, Randell E, Zhou H, Lu J, Meng QH (2013) D-lactate: a novel contributor to metabolic acidosis and high anion gap in diabetic ketoacidosis. Clin Chem 59:1406–1407CrossRefPubMed
83.
Jorens PG, Demey HE, Schepens PJ, Coucke V, Verpooten GA, Couttenye MM, Van Hoof V (2004) Unusual D-lactic acid acidosis from propylene glycol metabolism in overdose. J Toxicol Clin Toxicol 42:163–169CrossRefPubMed
84.
Tsao YT, Tsai WC, Yang SP (2008) A life-threatening double gap metabolic acidosis. Am J Emerg Med 26:385.e5–385.e6
85.
Mendu DR, Fleisher M, McCash SI, Pessin MS, Ramanathan LV (2015) D-lactic acidosis mediated neuronal encephalopathy in acute lymphoblastic leukemia patient: an under diagnosis. Clin Chim Acta 441:90–91CrossRefPubMed
86.
Duran M, Van Biervliet JP, Kamerling JP, Wadman SK (1977) D-lactic aciduria, an inborn error of metabolism? Clin Chim Acta 74:297–300CrossRefPubMed
87.
88.
Yasuda T, Ozawa S, Shiba C, Maeba T, Kanazawa T, Sugiyama M, Owada S, Ishida M (1993) D-lactate metabolism in patients with chronic renal failure undergoing CAPD. Nephron 63:416–422CrossRefPubMed
89.
Anderson YS, Curtis NJ, Hobbs JA, Thompson CH, Winearls CG, Radda GK, Clarke K, Altmann P (1997) High serum D-lactate in patients on continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant 12:981–983CrossRefPubMed
90.
Zar T, Graeber C, Perazella MA (2007) Recognition, treatment, and prevention of propylene glycol toxicity. Semin Dial 20:217–219CrossRefPubMed
91.
92.
Peruzzo M, Milani GP, Garzoni L, Longoni L, Simonetti GD, Bettinelli A, Fossali EF, Bianchetti MG (2010) Body fluids and salt metabolism - part II. Ital J Pediatr 36:78CrossRefPubMedPubMedCentral
Metadaten
Titel
D-lactic acidosis in humans: systematic literature review
verfasst von
Davide G. A. M. Bianchetti
Giacomo S. Amelio
Sebastiano A. G. Lava
Mario G. Bianchetti
Giacomo D. Simonetti
Carlo Agostoni
Emilio F. Fossali
Gregorio P. Milani
Publikationsdatum
07.12.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Nephrology / Ausgabe 4/2018
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-017-3844-8

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