title: A syndrome of severe hypoglycemia and acidosis in young immunosuppressed diabetic monkeys and pigs-association with sepsis.
abstract: BACKGROUND
  Large animals treated with immunosuppressive drugs for preclinical experiments of transplantation have increased risks of infection, which can be compounded by the induction of diabetes if islet transplantation is planned.
  
  
  METHODS
  We report our experience with severe sepsis in two young cynomolgus monkeys and five pigs that were subjected to diabetes induction, immunosuppressive therapy, or islet allotransplantation.
  
  
  RESULTS
  In two monkeys and five pigs, infection was associated with a syndrome of profound hypoglycemia accompanied by severe acidosis, which was resistant to treatment. We do not believe that this syndrome has been reported previously by others.
  
  
  CONCLUSIONS
  Despite treatment, this syndrome complicated the interpretation of blood glucose readings as a measure of islet graft function and resulted in death or the need for euthanasia in all seven animals. We tentatively suggest that the syndrome may be related to the presence of microorganisms that metabolize glucose and produce lactate.
authors.affiliation: Thomas E. Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Hao
authors.initials: H
authors.lastname: Zhou
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: van der Windt
authors.forename: Eefje M
authors.initials: EM
authors.lastname: Dons
authors.forename: Lora H
authors.initials: LH
authors.lastname: Rigatti
authors.forename: Gabriel J
authors.initials: GJ
authors.lastname: Echeverri
authors.forename: Rita
authors.initials: R
authors.lastname: Bottino
authors.forename: Martin
authors.initials: M
authors.lastname: Wijkstrom
authors.forename: Robert
authors.initials: R
authors.lastname: Wagner
authors.forename: David K C
authors.initials: DK
authors.lastname: Cooper
mesh_terms: D000138:Acidosis / Q000276:immunology* / Q000378:metabolism; D000818:Animals; D001419:Bacteria / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D003921:Diabetes Mellitus, Experimental / Q000276:immunology* / Q000378:metabolism / Q000601:surgery; D004195:Disease Models, Animal; D006084:Graft Rejection / Q000188:drug therapy / Q000276:immunology; D007003:Hypoglycemia / Q000276:immunology* / Q000378:metabolism; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects / Q000276:immunology*; D019344:Lactic Acid / Q000097:blood; D008252:Macaca fascicularis; D018805:Sepsis / Q000276:immunology* / Q000378:metabolism; D012720:Severity of Illness Index; D013552:Swine; D013577:Syndrome; D014184:Transplantation, Homologous
chemical_list: D001786:Blood Glucose; D007166:Immunosuppressive Agents; D019344:Lactic Acid