Lactic acidosis symptoms
Pro Research Analysisby 
Searched over 200M research papers
Consensus Meter
Symptoms of Lactic Acidosis: A Comprehensive Overview
Introduction to Lactic Acidosis Symptoms
Lactic acidosis is a serious medical condition characterized by the buildup of lactic acid in the body, leading to a decrease in blood pH. It can be classified into two main types: type A, which is associated with tissue hypoxia, and type B, which occurs without evidence of hypoxia. Understanding the symptoms of lactic acidosis is crucial for timely diagnosis and treatment.
General Symptoms of Lactic Acidosis
Metabolic Acidosis and Elevated Lactate Levels
Lactic acidosis is marked by metabolic acidosis and elevated blood lactate levels, typically higher than 5 mmol/L. Symptoms can vary depending on the underlying cause and severity of the condition.
Common Clinical Presentations
Patients with lactic acidosis often present with a range of symptoms including nausea, vomiting, and anorexia, which can lead to significant weight loss. Other common symptoms include abdominal pain, malaise, and fever. In severe cases, patients may experience rapid progression to multiple-organ failure.
Neurologic Symptoms in D-Lactic Acidosis
D-Lactic Acidosis and Neurologic Manifestations
D-lactic acidosis, a rare form of lactic acidosis, is often seen in individuals with short bowel syndrome or following certain types of gastrointestinal surgery. This condition is characterized by neurologic symptoms such as altered mental status, slurred speech, and ataxia, making patients appear intoxicated . These symptoms typically occur after the ingestion of high-carbohydrate foods, which are fermented by abnormal bacterial flora in the colon, leading to excessive D-lactate production and absorption.
Case Studies and Clinical Observations
In a systematic review, D-lactic acidosis was observed in patients ranging from 7 months to 86 years old, with symptoms including Kussmaul breathing, confusion, and gait disturbances. This condition is often under-recognized and should be considered in the differential diagnosis of unexplained high-gap metabolic acidosis.
Lactic Acidosis in HIV-Infected Patients
Symptoms in HIV-Infected Individuals
HIV-infected patients, particularly those on antiretroviral therapy, may develop lactic acidosis without obvious causes such as hypoxemia or sepsis. Symptoms in these patients can include nausea, emesis, anorexia, fever, malaise, and respiratory distress such as tachypnea and dyspnea . In some cases, lactic acidosis in HIV patients has been linked to the use of nucleoside analog reverse-transcriptase inhibitors (NRTIs) like zidovudine and stavudine.
Clinical Outcomes and Mortality
The prognosis for HIV-infected patients with lactic acidosis can be severe, with high mortality rates reported in cases where blood lactate levels exceed 9 mmol/L. In a study of seven HIV-infected patients, four died due to cardiovascular collapse secondary to progressive metabolic acidosis.
Lactic Acidosis in Diabetic Patients
Symptoms in Biguanide-Treated Diabetics
Diabetic patients treated with biguanides such as phenformin, buformin, and metformin are at risk of developing lactic acidosis. Symptoms in these patients often include severe metabolic acidosis, cardiovascular shock, and renal insufficiency. The mortality rate in these cases can be as high as 50.3%, particularly in older patients with more severe acidosis and higher blood lactate concentrations.
Conclusion
Lactic acidosis presents with a variety of symptoms that can range from gastrointestinal distress and weight loss to severe neurologic and respiratory manifestations. The condition can be life-threatening, especially in patients with underlying health issues such as HIV infection, diabetes, or short bowel syndrome. Early recognition and treatment of lactic acidosis are essential to improve patient outcomes.
Sources and full results
Most relevant research papers on this topic