title: Metformin-associated lactic acidosis in a low risk patient.
abstract: Metformin is an oral hypoglycemic agent belonging to the class of biguanides that are commonly used in the treatment of type II diabetes mellitus. Lactic acidosis is a rare but severe adverse reaction that occurs primarily in patients with contraindications such as renal failure. The case of a 71-year-old woman with type II diabetes, in whom severe metformin-associated lactic acidosis was precipitated by acute renal failure in the absence of pre-existing chronic renal failure or other absolute contraindications to biguanide use, is presented. Aggressive correction of the acidosis and prolonged dialysis resulted in a favourable outcome despite severe acidosis. The present case report shows that metformin-associated lactic acidosis can occur in patients without pre-existing renal insufficiency. Metformin should be temporarily stopped when acute renal failure occurs or is anticipated.
authors.affiliation: Department of Internal Medicine, Queen's University, Kingston, Ontario K7L 2V7, Canada. ellisa@kgh.kari.net
authors.forename: A K
authors.initials: AK
authors.lastname: Ellis
authors.forename: E A
authors.initials: EA
authors.lastname: Iliescu
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced* / Q000503:physiopathology; D058186:Acute Kidney Injury; D000368:Aged; D000075202:Contraindications; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D008687:Metformin / Q000009:adverse effects*; D006435:Renal Dialysis; D012306:Risk; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin