Lactic acidosis causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Lactic acidosis is one of the most common causes of high anion gap metabolic acidosis and is usually associated with a serum lactate levels above 4 mmol/L. Reduced oxygen tension shunts glycolysis towards pyruvate production, which in turn leads to lactate accumulation since pyruvate can no longer undergo aerobic metabolism.

Causes

Life Threatening Causes

Life-threatening causes include conditions which result in death or permanent disability within 24 hours if left untreated.

• Cardiac arrest
• Mesenteric ischemia
• Sepsis
• Shock

Common Causes

• Alcoholism
• Carbon monoxide poisoning
• Cyanide poisoning
• Exercise
• Grand mal seizure
• Hypoglycemia
• Hypoxemia
• Malignancy
• Metformin
• Pheochromocytoma
• Pulmonary edema
• Salicylate intoxication
• Stavudine
• Zidovudine

Causes by Organ System

Cardiovascular	Cardiac arrest, cardiac catheterization, cardiomyopathy, heart failure, hemorrhage, hypoperfusion, hypovolemia, multiple organ dysfunction syndrome, myocardial infarction, shock, ST elevation myocardial infarction complications
Chemical/Poisoning	Alcoholism, carbon monoxide poisoning, contrast medium, cyanide poisoning, ethanol, intravenous pyelogram, isopropyl alcohol
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Abacavir, adefovir, atenolol, biguanide, buformin, didanosine, emtricitabine, entecavir, lamivudine, linezolid, metformin, paracetamol, phenformin, Reye's syndrome, salicylate intoxication, stavudine, strychnine, telbivudine, tenofovir, zalcitabine
Ear Nose Throat	No underlying causes
Endocrine	Diabetic nephropathy, hypoglycemia, latent autoimmune diabetes, metabolic syndrome
Environmental	No underlying causes
Gastroenterologic	Acute liver failure, intestinal ischemia, liver failure, mesenteric ischemia, short bowel syndrome, small bowel bacterial overgrowth
Genetic	Fructose intolerance, fructose-1-phosphate aldolase deficiency, fructose-1,6-diphosphatase deficiency, glycogen storage disease, holocarboxylase synthase deficiency, MELAS, MERRF, mitochondrial myopathy, pyruvate carboxylase deficiency, pyruvate dehydrogenase deficiency, von Gierke disease
Hematologic	Anemia, Burkitt's lymphoma, leukemia, non Hodgkin's lymphoma
Iatrogenic	Cardiac catheterization
Infectious Disease	Acquired immune deficiency syndrome, sepsis, small bowel bacterial overgrowth
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	Ethylmalonic encephalopathy, grand mal seizure, seizures
Nutritional/Metabolic	Ariboflavinosis, beriberi heart disease, fructose intolerance, fructose-1-phosphate aldolase deficiency, fructose-1,6-diphosphatase deficiency, pyruvate carboxylase deficiency, pyruvate dehydrogenase deficiency, thiamine deficiency
Obstetric/Gynecologic	Fetal distress, oligohydramnios,
Oncologic	Burkitt's lymphoma, cancer, leukemia, non Hodgkin's lymphoma, pheochromocytoma,
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	Asthma, hypercapnia, hypoxia, pulmonary edema, respiratory failure
Renal/Electrolyte	Diabetic nephropathy, hemofiltration, renal failure
Rheumatology/Immunology/Allergy	Latent autoimmune diabetes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	Chronic fatigue syndrome, coenzyme q10 deficiency, exercise, glycogen storage disease, hypothermia, idiopathic, malignant hyperpyrexia, mitochondrial toxicity, smoke inhalation

Causes by Organ System developed by WikiDoc.org, Copyleft 2013

Causes in Alphabetical Order

• Abacavir
• Acquired immune deficiency syndrome
• Acute liver failure
• Adefovir
• Alcoholism
• Anemia
• Ariboflavinosis
• Asthma
• Atenolol
• Beriberi heart disease
• Biguanide
• Buformin
• Burkitt's lymphoma
• Cancer
• Carbon monoxide poisoning
• Cardiac arrest
• Cardiac catheterization
• Cardiomyopathy
• Chronic fatigue syndrome
• Coenzyme Q cytochrome c reductase deficiency
• Coenzyme Q10 deficiency
• Contrast medium
• Cyanide poisoning
• Diabetic nephropathy
• Didanosine
• Entecavir
• Ethanol
• Ethylmalonic encephalopathy
• Exercise
• Fetal distress
• Fructose intolerance

• Fructose-1-phosphate aldolase deficiency
• Fructose-1,6-diphosphatase deficiency
• Glycogen storage disease
• GRACILE syndrome
• Grand mal seizure
• Hemorrhage
• Heart failure
• Hemofiltration
• Liver failure
• Holocarboxylase synthase deficiency
• Hypercapnia
• Hypoglycemia
• Hypoperfusion
• Hypothermia
• Hypovolemia
• Hypoxia
• Idiopathic
• Intestinal ischemia
• Intravenous pyelogram
• Isopropyl alcohol
• Lamivudine
• Latent autoimmune diabetes
• Leukemia
• Linezolid
• Liver disease
• Malignant hyperpyrexia
• Malonyl-CoA decarboxylase deficiency
• MELAS
• MERRF
• Mesenteric ischemia
• Metabolic syndrome
• Metformin

• Mitochondrial myopathy
• Mitochondrial toxicity
• Multiple organ dysfunction syndrome
• Myocardial infarction
• Non Hodgkin's lymphoma
• Oligohydramnios
• Paracetamol
• Phenformin
• Pheochromocytoma
• Pulmonary edema
• Pyruvate carboxylase deficiency
• Pyruvate dehydrogenase deficiency
• Renal failure
• Respiratory failure
• Reye's syndrome
• Salicylate intoxication
• Seizures
• Sepsis
• Shock
• Short bowel syndrome
• Small bowel bacterial overgrowth syndrome
• Smoke inhalation
• ST elevation myocardial infarction complications
• Stavudine
• Stribild
• Strychnine
• Telbivudine
• Tenofovir
• Thiamine deficiency
• Tumors
• Von Gierke disease
• Zalcitabine

References

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