title: Unexpected survival from severe metformin-associated lactic acidosis.
abstract: Lactic acidosis is a recognised complication of the antihyperglycaemic biguanide agent metformin, especially in patients with renal failure. We report a case of severe lactic acidosis and hypothermia due to metformin treatment and renal impairment. The favourable outcome despite extremely unfavourable clinical signs and symptoms for survival after admission and initial treatment was unexpected. Specific aspects of the clinical course are addressed.
authors.affiliation: Department of Internal Medicine and Intensive Care, Gelderse Vallei Hospital, PO Box 9025, 6710 HN Ede, The Netherlands.
authors.forename: P J C M
authors.initials: PJ
authors.lastname: Schure
authors.forename: A
authors.initials: A
authors.lastname: de Gooijer
authors.forename: A R H
authors.initials: AR
authors.lastname: van Zanten
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced* / Q000503:physiopathology; D000368:Aged; D000075202:Contraindications; D003928:Diabetic Nephropathies / Q000188:drug therapy; D005260:Female; D006323:Heart Arrest; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008687:Metformin / Q000009:adverse effects* / Q000627:therapeutic use; D009426:Netherlands; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin