Lactic acidosis with hypoglycemia and hyperammonemia observed in two uremic patients during calcium hopantenate treatment.
Calcium hopantenate (HOPA), a drug for treating symptoms of cerebrovascular disease, is a derivative of gamma-amino butyric acid and is also an analog of pantothenic acid. It is speculated that calcium hopantenate may affect lactate generation, glucose metabolism, and ammonia disposal through the inhibition of pantothenic acid metabolism. We report two uremic patients with complaints of consciousness disturbance with lactic acidosis, hypoglycemia and hyperammonemia. HOPA is mainly excreted with urine. Severe accumulation of HOPA, documented at the onset of unconsciousness in our uremic cases, might be responsible for marked inhibition of pantothenic acid metabolism.
Otsuka
M
M
Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Akiba
T
T
Okita
Y
Y
Tomita
K
K
Yoshiyama
N
N
Sasaoka
T
T
Kanayama
M
M
Marumo
F
F
D000140:Acidosis, Lactic / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D000641:Ammonia / Q000097:blood*; D002331:Carnitine / Q000097:blood; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D008099:Liver / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010205:Pantothenic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood / Q000494:pharmacology; D014511:Uremia / Q000188:drug therapy*; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood / Q000494:pharmacology
C016030:pantogab; D010205:Pantothenic Acid; D005680:gamma-Aminobutyric Acid; D000641:Ammonia; D002331:Carnitine