Lactic acidosis causes: Difference between revisions
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==Overview== | ==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== | ==Causes== | ||
Revision as of 19:16, 22 July 2013
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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
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 | ST Elevation Myocardial Infarction Complications , Shock , Heart diseases , Cardiomyopathy , Cardiac arrest , Beriberi Heart Disease , Acute pulmonary edema |
| Chemical/Poisoning | Isopropyl alcohol , Ethanol , Cyanide intoxication , Crotalidae snake poisoning , Copperhead snake poisoning , Contrast medium , Complications During and Following Cardiac Catheterization, Carbon monoxide poisoning , Alcoholism |
| Dental | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | Zalcitabine , Tenofovir , Telbivudine , Succinyl-CoA synthetase deficiency , Stavudine , Phenformin , Paracetamol , Metformin , Linezolid , Lamivudine , Glyburide and Metformin , Entecavir , Emtricitabine , Didanosine , Buformin , Biguanide , Atenolol , Ariboflavinosis , Adefovir , Abacavir , Abacavir |
| Ear Nose Throat | No underlying causes |
| Endocrine | Pheochromocytoma , Latent autoimmune diabetes , Hypoglycemia , Diabetic nephropathy , Diabetes mellitus |
| Environmental | Smoke inhalation |
| Gastroenterologic | Short bowel syndrome , Mesenteric ischemia , Liver disease , Intestinal ischaemia , Hepatic failure , Bacterial overgrowth of small intestine , Acute liver failure |
| Genetic | Type I Glycogen Storage Disease , Type 1 glycogen storage disease , SCHAD deficiency , Pyruvate dehydrogenase phosphatase deficiency , Pyruvate dehydrogenase deficiency, Pyruvate decarboxylase deficiency, Pyruvate carboxylase deficiency, Pyridoxine-5'-phosphate oxidase deficiency, Myopathy with deficiency of succinate dehydrogenase and aconitase, Mitochondrial genome inherited conditions, Mitochondrial encephalomyopathy -- aminoacidopathy , Mitochondrial DNA depletion syndrome , Mitochondrial aspartyl-tRNA synthetase deficiency , Medium and long chan 3-hydroxyacyl-coenzyme A dehydrogenase deficiency , Malonyl-CoA decarboxylase deficiency, Malonyl-CoA decarboxylase deficiency , Malignant hyperpyrexia, Hydroxyacyl-coa dehydrogenase type 2 deficiency , Holocarboxylase synthase deficiency , GRACILE syndrome ,Glycogenosis type 1b, Glycogenosis type 1a, Glycogen Storage Disease Type I , Glycogen storage disease type 1D , Glycogen storage disease type 1C , Fructose-1,6-bisphosphatase deficiency, , Fructose-1,6-diphosphatase deficiency, Fructose-1-phosphate aldolase deficiency, Fructose intolerance, Dihydrolipoamide dehydrogenase deficiency, Decreased activity of pyruvate dehydrogenase , Decreased activity pyruvate carboxylase , 3-methylglutaconic aciduria, type 4 , 3-Hydroxyisobutyric aciduria, 3-Hydroxyacyl-CoA Dehydrogenase II Deficiency , 17- beta-hydroxysteroid dehydrogenase X deficiency |
| Hematologic | Burkitt's lymphoma |
| Iatrogenic | No underlying causes |
| Infectious Disease | Sepsis , Acquired immune deficiency syndrome |
| Musculoskeletal/Orthopedic | No underlying causes |
| Neurologic | Subacute necrotising encephalomyelopathy , Grand mal seizure , Ethylmalonic encephalopathy |
| Nutritional/Metabolic | Von Gierke Disease , Mitochondrial toxicity , Mitochondrial neurogastrointestinal encephalopathy syndrome , Mitochondrial myopathy , Impaired pyruvate utilization , Coenzyme Q10 deficiency |
| Obstetric/Gynecologic | Fetal distress |
| Oncologic | Non Hodgkin's lymphoma , Malignancy |
| Ophthalmologic | No underlying causes |
| Overdose/Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | Severehypoxemia (PO2 <25 to 30 mmHg) , Severe asthma , Respiratory failure , Lung disease - reduced oxygen intake , Hypoxia |
| Renal/Electrolyte | Renal failure , Hemofiltration |
| Rheumatology/Immunology/Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Miscellaneous | Succinic acidemia , Strychnine , Severe exercise , Reye's syndrome , Reduced oxygen utilization , Multiple organ dysfunction , Marked acidemia , Intravenous pyelogram , Idiopathic , Hypothermic shivering , Hypoperfusion , Haemorrhage , Finnish lethal neonatal metabolic syndrome , Decreased oxygen delivery , Cuffed blood sample, Chronic fatigue syndrome , MERRF , MELAS |