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{{Infobox_Disease |
__NOTOC__
  Name          = Lactic acidosis |
{{Lactic acidosis}}
  Image          = Lactic-acid-skeletal.png  |
'''For patient information, click [[Lactic Acidosis (patient information)|here]]'''
  Caption        = [[Lactic acid]] |
  DiseasesDB    = 29145 |
  ICD10          = {{ICD10|E|87|2|e|70}} |
  ICD9          = {{ICD9|276.2}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = 000391 |
  eMedicineSubj  = med |
  eMedicineTopic = 1253 |
  MeshName      = Lactic+Acidosis |
  MeshNumber    = C18.452.076.176.180 |
}}
{{CMG}}
{{CMG}}
__NOTOC__
{{Editor Help}}
==Overview==
'''Lactic acidosis''' is a condition caused by the buildup of [[lactic acid]] in the body. It leads to acidification of the blood ([[acidosis]]), and is considered a distinct form of [[metabolic acidosis]].
The cells produce lactic acid when they use [[glucose]] for energy in the absence of adequate [[oxygen]]. If too much lactic acid stays in the body, the balance tips and the person begins to feel ill. The signs of lactic acidosis are deep and rapid breathing, vomiting, and abdominal pain. Lactic acidosis may be caused by [[diabetic ketoacidosis]] or [[liver]] or [[kidney]] disease, as well as some forms of medication (most notably the anti-diabetic drug [[metformin]]).  Some anti-HIV drugs ([[antiretroviral]]s) warn doctors in their prescribing information to regularly watch for symptoms of lactic acidosis caused by [[mitochondrial toxicity]].
==Classification==
The ''Cohen-Woods classification'' (1976) categorises causes of lactic acidosis as follows:
* Type A: Decreased perfusion or oxygenation
* Type B:
** B1: Underlying diseases (sometimes causing type A)
** B2: Medication or intoxication
** B3: [[Inborn error of metabolism]]
Lactic acidosis is an underlying process of [[rigor mortis]].  Tissue in the muscles of the deceased resort to anaerobic metabolism in the absence of oxygen and significant amounts of lactic acid are released into the muscle tissue.  This along with the loss of [[adenosine triphosphate|ATP]] causes the muscles to grow stiff.
==Pathophysiology==


* [[Lactic Acidosis|Lactic acidosis]] occurs when cells make lactic acid faster than it can be metabolized. <ref>Sailer, Christian, Wasner, Susanne.  Differential Diagnosis Pocket.  Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref>  <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
{{SK}} Lactate levels raised (plasma or serum); lactic acidemia; lactic acidaemia.


{|  
==[[Lactic acidosis overview|Overview]]==
|-style="background:silver; color:black"
==[[Lactic acidosis historical perspective|Historical Perspective]]==
| '''Reference Range''' ||
==[[Lactic acidosis classification|Classification]]==
|-style="background:silver; color:black"
==[[Lactic acidosis pathophysiology|Pathophysiology]]==
| '''Capillary Blood''' || '''5-15 mg/dl'''
==[[Lactic acidosis causes|Causes]]==
|- style="background:silver; color:black"
==[[Lactic acidosis differential diagnosis|Differentiating Lactic acidosis from other Diseases]]==
| '''Deoxygenated Blood''' || '''-16 mg/dl'''
==[[Lactic acidosis epidemiology and demographics|Epidemiology and Demographics]]==
|-style="background:silver; color:black"
==[[Lactic acidosis risk factors|Risk Factors]]==
| '''Cerebrospinal Fluid (CSF)''' || '''11-19 mg/dl'''
==[[Lactic acidosis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
|}


== Differential Diagnosis ==  
==Diagnosis==
=== Increased ===
[[Lactic acidosis history and symptoms|History and Symptoms]] | [[Lactic acidosis physical examination|Physical Examination]] | [[Lactic acidosis laboratory findings|Laboratory Findings]]
* Drugs, toxins
* End-stage renal failure
* Fetal emergency situations during childbirth
* [[Glycogen storage disease]]
* Heart failure
* Heavy exercise
* [[Ddx:Hypothermia|Hypothermia]]
* [[Hypoventilation]] with [[hypercapnia]]
* [[Hypovolemia]]
* Infusions
* [[Leukemia]]
* Liver failure
* [[Myocardial Infarction]]
* Postoperative
* [[Seizures]]
* [[Sepsis]]
* Severe [[anemia]]
* Severe [[thiamine deficiency]]
* [[Tumors]]
* Uncontrolled [[diabetes mellitus]]


==See also==
==Treatment==
* [[Metabolic acidosis]]
[[Lactic acidosis medical therapy|Medical Therapy]] | [[Lactic acidosis primary prevention|Primary Prevention]] | [[Lactic acidosis secondary prevention|Secondary Prevention]] | [[Lactic acidosis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Lactic acidosis future or investigational therapies|Future or Investigational Therapies]]


==References==
==Case Studies==
{{Reflist|2}}


==Additional Resources==
* Clinical Physiology of Acid-Base and Electrolyte Disorders by Rose, Post
* Intensive Care Medicine by Irwin and Rippe
* The ICU Book by Marino
* Cohen R, Woods H. ''Clinical and Biochemical Aspects of Lactic Acidosis''. Blackwell Scientific Publications; 1976. ISBN 0-632-09460-5.


[[Category:Electrolyte disturbance]]
[[Category:Electrolyte disturbance]]
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[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[Category:Intensive care medicine]]
{{Endocrine, nutritional and metabolic pathology}}
[[Category:Inborn errors of metabolism]]


[[es:Acidosis láctica]]
[[es:Acidosis láctica]]
[[pl:Kwasica mleczanowa]]
[[pl:Kwasica mleczanowa]]
[[pt:Acidose láctica]]
[[pt:Acidose láctica]]


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Latest revision as of 21:08, 4 February 2022

Lactic acidosis Microchapters

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For patient information, click here Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Lactate levels raised (plasma or serum); lactic acidemia; lactic acidaemia.

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Lactic acidosis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings

Treatment

Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies


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