A Unique Case of Metformin-Associated Lactic Acidosis
Metformin-associated lactic acidosis [MALA] is a potentially fatal condition characterized by an elevation in serum lactate in patients with metformin exposure. An 82-year-old man with no prior renal history was brought to hospital after being found by his family in a confused state. He had a histor...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2018/4696182 |
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| author | Benjamin Gershkovich Christopher McCudden Kevin D. Burns |
| author_facet | Benjamin Gershkovich Christopher McCudden Kevin D. Burns |
| author_sort | Benjamin Gershkovich |
| collection | DOAJ |
| description | Metformin-associated lactic acidosis [MALA] is a potentially fatal condition characterized by an elevation in serum lactate in patients with metformin exposure. An 82-year-old man with no prior renal history was brought to hospital after being found by his family in a confused state. He had a history of type 2 diabetes mellitus, and his medications included regular metformin. On arrival to our hospital he was conscious but confused and noted recent decreased oral intake. Initial investigations revealed severe acidemia (pH <6.75, undetectable bicarbonate), with elevated serum lactate, urea, creatinine, and hyperkalemia. He was treated with intravenous dextrose, crystalloids, and bicarbonate and underwent urgent hemodialysis. The patient responded well to supportive therapies and achieved full renal recovery one week after admission. He was discharged feeling well, with a new antihyperglycemic medication regimen. This case highlights the potential for life-threatening acidemia in cases of MALA. The case is further unique in that the patient was conscious and responded to questions on arrival, despite the serious metabolic disturbance, and recovered completely. From a safety standpoint, health care providers should advise and educate their patients about discontinuing metformin and other potentially harmful medications in the context of acute illness with volume contraction. |
| format | Article |
| id | doaj-art-742fdb50094846bc8f026cfff7ceb3be |
| institution | Kabale University |
| issn | 2090-6641 2090-665X |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Nephrology |
| spelling | doaj-art-742fdb50094846bc8f026cfff7ceb3be2025-02-03T01:29:58ZengWileyCase Reports in Nephrology2090-66412090-665X2018-01-01201810.1155/2018/46961824696182A Unique Case of Metformin-Associated Lactic AcidosisBenjamin Gershkovich0Christopher McCudden1Kevin D. Burns2Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, CanadaDepartment of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, CanadaDepartment of Medicine, Division of Nephrology, Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, CanadaMetformin-associated lactic acidosis [MALA] is a potentially fatal condition characterized by an elevation in serum lactate in patients with metformin exposure. An 82-year-old man with no prior renal history was brought to hospital after being found by his family in a confused state. He had a history of type 2 diabetes mellitus, and his medications included regular metformin. On arrival to our hospital he was conscious but confused and noted recent decreased oral intake. Initial investigations revealed severe acidemia (pH <6.75, undetectable bicarbonate), with elevated serum lactate, urea, creatinine, and hyperkalemia. He was treated with intravenous dextrose, crystalloids, and bicarbonate and underwent urgent hemodialysis. The patient responded well to supportive therapies and achieved full renal recovery one week after admission. He was discharged feeling well, with a new antihyperglycemic medication regimen. This case highlights the potential for life-threatening acidemia in cases of MALA. The case is further unique in that the patient was conscious and responded to questions on arrival, despite the serious metabolic disturbance, and recovered completely. From a safety standpoint, health care providers should advise and educate their patients about discontinuing metformin and other potentially harmful medications in the context of acute illness with volume contraction.http://dx.doi.org/10.1155/2018/4696182 |
| spellingShingle | Benjamin Gershkovich Christopher McCudden Kevin D. Burns A Unique Case of Metformin-Associated Lactic Acidosis Case Reports in Nephrology |
| title | A Unique Case of Metformin-Associated Lactic Acidosis |
| title_full | A Unique Case of Metformin-Associated Lactic Acidosis |
| title_fullStr | A Unique Case of Metformin-Associated Lactic Acidosis |
| title_full_unstemmed | A Unique Case of Metformin-Associated Lactic Acidosis |
| title_short | A Unique Case of Metformin-Associated Lactic Acidosis |
| title_sort | unique case of metformin associated lactic acidosis |
| url | http://dx.doi.org/10.1155/2018/4696182 |
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