title: [Lactic acidosis after administration of buformine (author's transl)].
abstract: An 85-year-old female diabetic was admitted in coma, having been on antidiabetic treatment with the biguanide derivative "Silubin retard", 600 mg/d, for one-and-a-half months. The anion deficiency was 57 mmol/l, pH 6.9, suggesting the diagnosis of lactic acidosis in the absence of other causes of metabolic acidosis. Blood lactic acid levels of more than 16.65 mmol/l (150 mg/100 ml) confirmed the diagnosis. Administration of 875 mmol sodium bicarbonate over 12 hours corrected the deficiency. On admission to hospital there had been slight pre-renal failure. Myocardial infarction developed as a result of tissue hypoxia but did not prove clinically important. On the second day there were signs of a compensated disseminated intravascular coagulopathy with upper gastro intestinal haemorrhage. The woman died suddenly 18 days later of pulmonary embolism.
mesh_terms: D000138:Acidosis / Q000139:chemically induced* / Q000188:drug therapy; D000368:Aged; D001639:Bicarbonates / Q000627:therapeutic use; D001645:Biguanides / Q000009:adverse effects*; D002026:Buformin / Q000009:adverse effects* / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000188:drug therapy*; D003926:Diabetic Coma / Q000139:chemically induced; D005260:Female; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D007773:Lactates / Q000097:blood*
chemical_list: D001639:Bicarbonates; D001645:Biguanides; D007328:Insulin; D007773:Lactates; D002026:Buformin
vernacular_title: Lactat-Acidose nach Buformin-Medikation