Lactic acidosis differential diagnosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Saud Khan M.D.
Overview
Lactic acidosis must be differentiated from other diseases that cause elevated lactate Any shock state or dysfunction of the metabolic pathway responsible for lactate clearance or production can underlie lactic acidosis. A few are:
- Inborn errors of metabolism
- Cardiogenic shock
- Cardiogenic pulmonary edema
Differentiating Lactic acidosis from other Diseases
Lactic acidosis should be differentiated from:
- Any shock state
- SIRS; lactate may be 2-5 mEq/L
- Thiamine deficiency
- D-lactic acidosis
- Seizures
- Infarcted colon
- Hepatic failure
- Malignancy
- Heavy exercise
- Albuterol and other beta agonists
- Toxicologic Causes:
- Cyanide
- Carbon Monoxide
- Metformin use in diabetics
- Didanosine
- Stavudine
- Zidovudine
- Linezolid
- Strychnine
- Rotenone (Fish Poison)
- Phospine (rodenticide)
- INH (if patient seizes)
- Valproate
- Hydrogen Sulfide
- Nitroprusside (cyanide)
- Ricin & Castor Beans
- Propofol
- Sympathomimetics (cocaine, methamphetamine)
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