Lactate production in type B hyperlactataemia due to infective encephalopathy.
We have suggested that the neuroglycopenia of infective encephalopathy results in increased lactate production in muscle as an alternative cerebral fuel. Two probable mechanisms for enhanced lactate production in infective encephalopathy are fatty acidaemia and increased LDH activity. Hyperglycaemia-producing infusions should then result in clinical and metabolic recovery. Twenty-two children with encepahlopathy were studied over 2 1/2 week periods. There was normoglycaemia at admission together with hyperlactataemia (p less than 0.004), fatty acidaemia (p less than 0.004) and increased serum LDH activity (p less than 0.005). Therapeutic hyperglycaemia resulted in recovery and a progressive return of metabolic aberrations to normality. Two case reports detail the responses to such management.
Aiyathurai
J E
JE
Wong
H B
HB
Quak
S H
SH
Low
P S
PS
Sothy
S P
SP
Sivanandasingham
P
P
Jacob
E
E
Chio
L F
LF
D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004660:Encephalitis / Q000378:metabolism* / Q000628:therapy; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D006943:Hyperglycemia / Q000378:metabolism; D007223:Infant; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007773:Lactates / Q000096:biosynthesis* / Q000097:blood; D019344:Lactic Acid; D008297:Male; D012202:Reye Syndrome / Q000378:metabolism / Q000628:therapy
D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007773:Lactates; D019344:Lactic Acid; D007770:L-Lactate Dehydrogenase; D005947:Glucose