title: A case of D-lactic acid encephalopathy associated with use of probiotics.
abstract: A five year old girl was admitted to the hospital for evaluation of intermittent ataxia. She had undergone serial resections of the small intestine after birth, resulting in short bowel syndrome. Lactomin was prescribed for watery diarrhea at twice the regular dose 2 weeks before the onset of neurologic symptoms. D-lactic acidosis was diagnosed on the basis of a plasma D-lactate level of 5.537 mmol/l. Lactomin was discontinued, and she was treated with sodium bicarbonate and oral antibiotics. The probiotics the patient had taken were likely the cause of D-lactic acidosis and should therefore be avoided in patients with short bowel syndrome.
authors.affiliation: Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan. shun-m@jb3.so-net.ne.jp
authors.forename: Shun
authors.initials: S
authors.lastname: Munakata
authors.forename: Chikako
authors.initials: C
authors.lastname: Arakawa
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Kohira
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Fujita
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Fuchigami
authors.forename: Hideo
authors.initials: H
authors.lastname: Mugishima
mesh_terms: D000140:Acidosis, Lactic / Q000150:complications* / Q000209:etiology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D020258:Neurotoxicity Syndromes / Q000209:etiology* / Q000503:physiopathology; D019936:Probiotics / Q000009:adverse effects*; D012778:Short Bowel Syndrome / Q000150:complications*