title: D-lactic acidosis mediated neuronal encephalopathy in acute lymphoblastic leukemia patient: an under diagnosis.
abstract: BACKGROUND
  D-lactic acidosis, also referred as D-lactate encephalopathy, has been reported in patients with short bowl syndrome (SBS).
  
  
  METHODS
  The neurologic symptoms include altered mental status, slurred speech, and ataxia. Onset of neurological symptoms is accompanied by metabolic acidosis and high anion gap. We present here a case of D-lactic acidosis in a patient with acute lymphoblastic leukemia (ALL) who developed severe neurological symptoms and metabolic acidosis due to vancomycin-resistant enterococci (VRE) infection, and elevated D-lactic acid.
authors.affiliation: Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States of America.
authors.forename: Damodara Rao
authors.initials: DR
authors.lastname: Mendu
authors.affiliation: Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States of America.
authors.forename: Martin
authors.initials: M
authors.lastname: Fleisher
authors.affiliation: Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States of America.
authors.forename: Samuel I
authors.initials: SI
authors.lastname: McCash
authors.affiliation: Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States of America.
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Pessin
authors.affiliation: Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States of America. Electronic address: ramanatl@mskcc.org.
authors.forename: Lakshmi V
authors.initials: LV
authors.lastname: Ramanathan
mesh_terms: D000140:Acidosis, Lactic / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism; D000368:Aged; D001927:Brain Diseases / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D006801:Humans; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism
keywords: D-lactic acid; Hematological malignancy; Neuropathy