Signs and symptoms of lactic acidosis
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Signs and Symptoms of Lactic Acidosis
Overview of Lactic Acidosis
Lactic acidosis is a serious metabolic condition characterized by the buildup of lactic acid in the body, leading to a decrease in blood pH. It can occur due to various underlying conditions such as tissue hypoxia, hepatic dysfunction, and certain medications like biguanides used in diabetes treatment Suppa2012Luft1978. This article explores the common signs and symptoms associated with lactic acidosis, drawing from multiple research studies.
Common Symptoms of Lactic Acidosis
General Symptoms
Lactic acidosis can present with a range of symptoms, some of which may be nonspecific and easily overlooked. Common symptoms include:
- Nausea and Vomiting: These gastrointestinal symptoms are frequently reported in patients with lactic acidosis Suppa2012Coghlan2001.
- Asthenia (Weakness): Generalized weakness or fatigue is another common symptom .
- Abdominal Pain: This is particularly noted in patients with HIV on antiretroviral therapy .
Respiratory Symptoms
- Hyperpnoea: One of the distinctive symptoms of lactic acidosis is hyperpnoea, which involves an increased depth and frequency of breathing .
- Tachypnea and Dyspnea: Rapid breathing and shortness of breath are also observed, especially in severe cases Chattha1993Gérard2000.
Neurological Symptoms
- Confusion and Altered Mental Status: Patients may experience confusion, slurred speech, and other cognitive disturbances, particularly in cases of D-lactic acidosis Bianchetti2018Petersen2005.
- Ataxia: Difficulty in coordinating movements, often described as appearing drunk, is another symptom associated with D-lactic acidosis .
Severe Symptoms and Complications
Cardiovascular Symptoms
- Cardiovascular Shock: Severe lactic acidosis can lead to cardiovascular shock due to reduced myocardial contractility Suppa2012Luft1978.
- Tachycardia: An increased heart rate is often observed in patients with symptomatic hyperlactatemia .
Metabolic and Systemic Symptoms
- Metabolic Acidosis: A hallmark of lactic acidosis is metabolic acidosis, characterized by a blood lactate level higher than 5 mmol/L and a blood pH less than 7.35 Chattha1993Luft1983.
- Multiple-Organ Failure: In severe cases, rapid progression to multiple-organ failure can occur, particularly in patients with HIV on antiretroviral therapy .
Conclusion
Lactic acidosis presents with a variety of symptoms ranging from mild gastrointestinal and respiratory issues to severe cardiovascular and neurological complications. Recognizing these signs early is crucial for timely diagnosis and management. Understanding the diverse presentation of lactic acidosis can aid healthcare providers in identifying and treating this potentially life-threatening condition effectively.
Sources and full results
Most relevant research papers on this topic
Lactic acidosis in biguanide-treated diabetics
Biguanide treatment for diabetes mellitus should be reserved for specially selected patients, as lactic acidosis is more likely to develop in older, more advanced diabetics with certain predisposing factors.
D-lactic acidosis in humans: systematic literature review
D-lactic acidosis is a common and under-recognized condition in individuals with short bowel syndrome or carbohydrate malabsorption, and may contribute to acidosis in diabetes mellitus and propylene glycol intoxication.
D-lactic acidosis.
D-lactic acidosis is a rare neurologic syndrome caused by malabsorbed carbohydrates fermented by abnormal bacterial flora in the colon, with potential factors contributing to neurologic symptoms.
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Symptomatic lactic acidosis in hospitalized antiretroviral-treated patients with human immunodeficiency virus infection: a report of 12 cases.
Symptomatic lactic acidosis in hospitalized HIV patients may be more common in those with extensive prior exposure to nucleoside analog reverse-transcriptase inhibitors.
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