title: D-lactic acidosis in short-bowel syndrome managed with antibiotics and probiotics.
abstract: D-lactic acidosis sometimes occurs in malabsorbed patients with short-bowel syndrome and is characterized by recurrent episodes of encephalopathy and metabolic acidosis. The characteristic neurologic abnormalities and the presence of metabolic acidosis raises a diagnostic suspicion, and the diagnosis is made when the serum level of D-lactic acid is greater than 3 mmol/L. Standard treatment consists of restricting oral carbohydrates or fasting, correction of metabolic acidosis, and a long-term suppression of pathogenic floras with antibiotics. The authors present a case of D-lactic acidosis in a 22-year-old patient with short-bowel syndrome, to whom intestinal bacterial agents (probiotics) were given in addition to oral kanamycin. Recolonization of the intestine with nonpathogenic floras should be a long-term treatment for D-lactic acidosis.
authors.affiliation: Department of Pediatric Surgery, Dokkyo University School of Medicine, Koshigaya Hospital, Koshigaya, Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Uchida
authors.forename: Hideki
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kisaki
authors.forename: Junko
authors.initials: J
authors.lastname: Fujino
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ishimaru
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ikeda
mesh_terms: D000140:Acidosis, Lactic / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001644:Bifidobacterium; D003244:Consciousness Disorders / Q000209:etiology; D004401:Dysarthria / Q000209:etiology; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D007612:Kanamycin / Q000627:therapeutic use*; D007780:Lacticaseibacillus casei; D008297:Male; D019936:Probiotics / Q000627:therapeutic use*; D012778:Short Bowel Syndrome / Q000150:complications* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D007612:Kanamycin