title: D-lactic acidosis: a treatable encephalopathy in pediatric patients.
abstract: A 20-month old infant, who had short bowel syndrome following extensive surgery for a mid gut volvulus, developed hyperchloremic acidosis, with a large anion gap after enteral feeding was instituted. The organic acidosis was at least partly due to an increased concentration of D-lactic acid. This patient, as did five other pediatric patients, presented with a typical encephalopathy syndrome. Early recognition of this syndrome and treatment with an intestinal antibiotic and discontinuation of enteral feeding enabled prompt correction of the hyperchloremic acidosis and a rapid clinical recovery.
authors.affiliation: Department of Pediatrics, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: J
authors.initials: J
authors.lastname: Gurevitch
authors.forename: B
authors.initials: B
authors.lastname: Sela
authors.forename: A
authors.initials: A
authors.lastname: Jonas
authors.forename: H
authors.initials: H
authors.lastname: Golan
authors.forename: Y
authors.initials: Y
authors.lastname: Yahav
authors.forename: J H
authors.initials: JH
authors.lastname: Passwell
mesh_terms: D000140:Acidosis, Lactic / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D001928:Brain Diseases, Metabolic / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D004750:Enteral Nutrition; D006801:Humans; D007223:Infant; D007773:Lactates / Q000378:metabolism; D019344:Lactic Acid; D008297:Male; D012778:Short Bowel Syndrome / Q000150:complications
chemical_list: D007773:Lactates; D019344:Lactic Acid