What is lactic acidosis symptoms
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Symptoms of Lactic Acidosis: A Comprehensive Overview
Introduction to Lactic Acidosis Symptoms
Lactic acidosis is a serious metabolic condition characterized by the buildup of lactic acid in the body, leading to a decrease in blood pH. This condition can arise from various underlying causes, including tissue hypoxia, certain medications, and metabolic disorders. Understanding the symptoms of lactic acidosis is crucial for timely diagnosis and treatment.
General Symptoms of Lactic Acidosis
Vague and Non-Specific Symptoms
Lactic acidosis can present with a range of non-specific symptoms that may not immediately suggest a metabolic disorder. Common symptoms include general weakness (asthenia), nausea, and vomiting. These symptoms can be easily overlooked or attributed to other less severe conditions.
Respiratory Symptoms
A distinctive symptom of lactic acidosis is hyperpnoea, which involves an increased depth and frequency of breathing. This respiratory response is the body's attempt to compensate for the acidotic state by expelling more carbon dioxide.
Severe Symptoms
In more severe cases, lactic acidosis can lead to cardio circulatory shock due to reduced myocardial contractility and progressive sensory alterations. This can be life-threatening if not promptly addressed.
Symptoms in Specific Conditions
HIV-Related Lactic Acidosis
Patients with HIV, particularly those on antiretroviral therapy, may develop lactic acidosis with symptoms such as nausea, vomiting, anorexia, weight loss, fever, malaise, tachypnea, and dyspnea . These symptoms can be severe and may lead to rapid progression to multiple-organ failure if not treated urgently.
D-Lactic Acidosis
D-lactic acidosis, often seen in individuals with short bowel syndrome or following jejuno-ileal bypass surgery, presents with neurologic symptoms such as altered mental status, slurred speech, and ataxia, making patients appear intoxicated . These neurologic symptoms are accompanied by metabolic acidosis and elevated plasma D-lactate levels.
Cancer-Related Lactic Acidosis
In cases of hematological malignancies, such as acute lymphoblastic leukemia, lactic acidosis can present with severe chest pain, dyspnea, systemic symptoms, and significant metabolic acidosis. This type of lactic acidosis is often secondary to the Warburg effect, where cancer cells switch from oxidative to glycolytic metabolism.
Drug-Induced Lactic Acidosis
Antiretroviral Drugs
Lactic acidosis is a known adverse reaction to nucleoside HIV reverse transcriptase inhibitors. Symptoms include gastrointestinal upset, fatigue, fever, and breathlessness, which appear gradually after weeks or months of treatment. Hyperlactataemia should be suspected in patients on these medications who present with unexplained symptoms, especially breathlessness.
Biguanides in Diabetics
Diabetic patients treated with biguanides (e.g., metformin) can develop lactic acidosis, particularly if they have accompanying illnesses or are on additional medications. Symptoms in these patients include cardiovascular shock, severe acidosis, and high blood lactate concentrations.
Conclusion
Lactic acidosis presents with a variety of symptoms that can range from mild and non-specific to severe and life-threatening. Recognizing these symptoms early, especially in high-risk populations such as those with HIV, short bowel syndrome, or on specific medications, is essential for prompt diagnosis and treatment. Understanding the diverse presentations of lactic acidosis can aid healthcare providers in managing this serious condition effectively.
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