title: [Metformin-induced lactic acidosis : Severe symptoms with difficult diagnostics].
abstract: Metformin-induced lactic acidosis is a rare but severe disease for the individual patients. A case of a 64-year-old patient with diabetes mellitus type 2 suffering from this disease is presented where metformin accumulation was caused by prerenal acute kidney failure. The clinical evaluation up to the final diagnosis, the pathophysiology and the appropriate therapy are presented in detail. Additionally, the current guidelines regarding the perioperative management of metformin administration are summarized. The case described aims to direct attention to the rare but, nevertheless, severe symptoms of metformin-induced lactic acidosis.
authors: Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland, sebastian.decker@med.uni-heidelberg.de.
authors: S O
authors: SO
authors: Decker
authors: M
authors: M
authors: Wortmann
authors: B H
authors: BH
authors: Siegler
authors: A
authors: A
authors: Ulrich
authors: S
authors: S
authors: Hofer
authors: T
authors: T
authors: Brenner
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced* / Q000175:diagnosis*; D058186:Acute Kidney Injury / Q000378:metabolism / Q000628:therapy; D002245:Carbon Dioxide / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy; D004837:Epinephrine / Q000097:blood; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008687:Metformin / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D019990:Perioperative Care; D006435:Renal Dialysis
chemical_list: D007004:Hypoglycemic Agents; D002245:Carbon Dioxide; D019344:Lactic Acid; D008687:Metformin; D009638:Norepinephrine; D004837:Epinephrine