title: D-lactic acidosis: an unusual cause of encephalopathy in a patient with short bowel syndrome.
abstract: A 24-year-old woman with a short bowel syndrome following post-ischemic small bowel resection, developed several episodes of lethargy, echolalia and ataxia. D-lactic acidosis was identified as the cause of neurological disturbances. This infrequent disorder can be precipitated by intake of a large amount of sugars, in patients with short bowel syndrome. It should be suspected in the presence of metabolic acidosis with increased anion gap and a normal level of L-lactic acid. The diagnosis relies on the specific dosage of D-lactic stereoisomer. Proper management involves rehydration, diet adaptation and oral administration of poorly absorbed antibiotics in order to modify the colonic flora responsible for D-lactic production.
authors.affiliation: Internal Medicine Department, Cliniques Universitaires St-Luc, Université catholique de Louvain, Brussels, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Dahlqvist
authors.forename: M A
authors.initials: MA
authors.lastname: Guillen-Anaya
authors.forename: M F
authors.initials: MF
authors.lastname: Vincent
authors.forename: J P
authors.initials: JP
authors.lastname: Thissen
authors.forename: P
authors.initials: P
authors.lastname: Hainaut
mesh_terms: D000140:Acidosis, Lactic / Q000209:etiology*; D001927:Brain Diseases / Q000209:etiology*; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D005260:Female; D006801:Humans; D012778:Short Bowel Syndrome / Q000150:complications*; D055815:Young Adult
chemical_list: D004040:Dietary Carbohydrates