D-lactic acidosis: a treatable encephalopathy in pediatric patients.
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.
Gurevitch
J
J
Department of Pediatrics, Sheba Medical Center, Tel Hashomer, Israel.
Sela
B
B
Jonas
A
A
Golan
H
H
Yahav
Y
Y
Passwell
J H
JH
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
D007773:Lactates; D019344:Lactic Acid