Symptoms of lactic acidosis
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Symptoms of Lactic Acidosis
Introduction to Lactic Acidosis
Lactic acidosis is a serious metabolic condition characterized by an elevated level of lactate in the blood, leading to a decrease in blood pH. It can be classified into two types: type A, which is associated with tissue hypoxia, and type B, which occurs without evidence of tissue hypoxia. This article explores the symptoms associated with lactic acidosis, drawing insights from various research studies.
Common Symptoms of Lactic Acidosis
Gastrointestinal Symptoms: Nausea, Vomiting, and Abdominal Pain
One of the most frequently reported symptoms of lactic acidosis is gastrointestinal distress. Patients often present with nausea, vomiting, and abdominal pain. These symptoms are particularly common in patients with HIV who are treated with antiretroviral drugs, such as nucleoside analog reverse-transcriptase inhibitors (NRTIs). In a study of 12 hospitalized HIV patients with lactic acidosis, 11 presented with abdominal pain, nausea, and/or emesis.
Respiratory Symptoms: Hyperventilation and Dyspnea
Respiratory symptoms are also prominent in lactic acidosis. Hyperventilation, characterized by rapid and deep breathing, is a distinctive symptom. This is often accompanied by dyspnea, or difficulty breathing. In a study involving HIV-infected patients, three out of seven patients presented with tachypnea and dyspnea. Hyperpnoea, an increased depth and frequency of breathing, is another respiratory symptom associated with severe acidosis.
Neurological Symptoms: Confusion and Altered Mental Status
Neurological symptoms such as confusion, slurred speech, and altered mental status are particularly noted in cases of D-lactic acidosis, a rare form of lactic acidosis often seen in patients with short bowel syndrome or following jejuno-ileal bypass surgery . These symptoms can make patients appear intoxicated and are accompanied by metabolic acidosis and elevated plasma D-lactate levels.
Systemic Symptoms: Fatigue, Malaise, and Weight Loss
Systemic symptoms like fatigue, malaise, and significant weight loss are also common. In a study of HIV patients, some presented with fever and malaise, while others experienced anorexia and weight loss. Acute weight loss was observed in eight patients with a mean loss of 12 kg.
Cardiovascular Symptoms: Cardiovascular Collapse and Shock
Severe lactic acidosis can lead to cardiovascular complications, including cardiovascular collapse and shock. This is due to reduced myocardial contractility and progressive sensory alteration. In a study of diabetic patients treated with biguanides, cardiovascular shock was a frequent complication, contributing to a high mortality rate.
Conclusion
Lactic acidosis presents with a variety of symptoms that can affect multiple organ systems. Common symptoms include gastrointestinal distress, respiratory issues, neurological disturbances, systemic fatigue, and cardiovascular complications. Recognizing these symptoms early is crucial for prompt diagnosis and treatment, which can significantly improve patient outcomes.
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