Don't Forget To Test for D-Lactic Acid in Short Bowel Syndrome

Godey, Florence; Bouasria, Abderrezak; Ropert, Martine; Diakité, Mandiou; Treut, A. Le; Balençon, M.

doi:10.1111/j.1572-0241.2000.03416.x

Cited by 19 publications

(5 citation statements)

References 6 publications

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“…However, there have been reports refuting this causal association. Godey et al [ 30 ] described a case of a 2-year-old female who was diagnosed with lactic acidosis and neurological symptoms. Patient had recurrences of neurological symptoms with elevated D-lactate but without significant acidosis 6 months from the original diagnosis.…”

Section: Review Of Clinical Features Of D-lactic Acidosismentioning

confidence: 99%

“…Other theories include decreasing activity of pyruvate dehydrogenase with D-lactate accumulation due to a reduction in the pH [ 33 ]. While the pyruvate theory explains many of the clinical manifestations, there has been a case report of D-la where pyruvate levels were normal during acute neurological symptoms [ 30 ].…”

Section: Review Of Clinical Features Of D-lactic Acidosismentioning

confidence: 99%

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D-Lactic Acidosis: An Underrecognized Complication of Short Bowel Syndrome

Kowlgi

Chhabra

2015

Gastroenterology Research and Practice

124

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D-lactic acidosis or D-lactate encephalopathy is a rare condition that occurs primarily in individuals who have a history of short bowel syndrome. The unabsorbed carbohydrates act as a substrate for colonic bacteria to form D-lactic acid among other organic acids. The acidic pH generated as a result of D-lactate production further propagates production of D-lactic acid, hence giving rise to a vicious cycle. D-lactic acid accumulation in the blood can cause neurologic symptoms such as delirium, ataxia, and slurred speech. Diagnosis is made by a combination of clinical and laboratory data including special assays for D-lactate. Treatment includes correcting the acidosis and decreasing substrate for D-lactate such as carbohydrates in meals. In addition, antibiotics can be used to clear colonic flora. Although newer techniques for diagnosis and treatment are being developed, clinical diagnosis still holds paramount importance, as there can be many confounders in the diagnosis as will be discussed subsequently.

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Section: Review Of Clinical Features Of D-lactic Acidosismentioning

confidence: 99%

Section: Review Of Clinical Features Of D-lactic Acidosismentioning

confidence: 99%

D-Lactic Acidosis: An Underrecognized Complication of Short Bowel Syndrome

Kowlgi

Chhabra

2015

Gastroenterology Research and Practice

124

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“…[35][36][37][38][39] Furthermore, uninterrupted antibiotic treatment (cotrimoxazole), administered in alternating cycles, together with probiotic administration, has certainly reduced intestinal pathogen bacterial contamination and growth, therefore reducing the risk of developing the SIBO syndrome, and, to date, there have been no side-effects, nor has the treatment promoted the growth of lactobacilli leading to lacticoacidosis, as it has been previously hypothesized. [40][41][42] However, a continuous assumption of oral bicarbonate is still needed and the quite frequent episodes of severe acidosis require an extremely large amount of intravenous bicarbonate.…”

Section: Discussionmentioning

confidence: 99%

Clinical case and short review of extreme short bowel syndrome: an update 21 years after

et al. 2016

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Short bowel syndrome refers to the malabsorptive state caused by loss of significant portions of the small intestine, whose clinical framework is characterized by malnutrition, diarrhea, dehydration, weight loss, and low-weight-related symptoms/signs. These clinical conditions seem to be related to the length of resection. Twenty-one years ago we reported the clinical case of an infant, who underwent a massive resection of the loops of the small intestine, of the cecum and of part of the ascending colon, due to intestinal malrotation with volvulus. The residual small intestine measured just 11 cm and consisted of the duodenum and a small part of jejunum, in the absence of the ileocecal valve, configuring the case of a ultra-short bowel syndrome. In this report, we update the case, reporting the patient succeeded to obtain a good weight gain and to conduct a quite normal lifestyle, despite the long-term consequences of such resection.

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“…The urine anion gap may also be increased. In cases of D-lactic acidosis with hyperchloremic acidosis and an increased anion gap in the urine, a misdiagnosis of renal tubular acidosis (RTA) is possible [ 42 , 43 ]. However, analyzing the urine osmolarity gap to calculate excreted NH4+ can help in these cases, as NH4+ excretion is high in D-lactic acidosis but low in RTA [ 12 ].…”

Section: D-lactate In Health and Diseasementioning

confidence: 99%

D-Lactate: Implications for Gastrointestinal Diseases

Remund,

Yilmaz,

Sokollik

2023

Children

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D-lactate is produced in very low amounts in human tissues. However, certain bacteria in the human intestine produce D-lactate. In some gastrointestinal diseases, increased bacterial D-lactate production and uptake from the gut into the bloodstream take place. In its extreme, excessive accumulation of D-lactate in humans can lead to potentially life-threatening D-lactic acidosis. This metabolic phenomenon is well described in pediatric patients with short bowel syndrome. Less is known about a subclinical rise in D-lactate. We discuss in this review the pathophysiology of D-lactate in the human body. We cover D-lactic acidosis in patients with short bowel syndrome as well as subclinical elevations of D-lactate in other diseases affecting the gastrointestinal tract. Furthermore, we argue for the potential of D-lactate as a marker of intestinal barrier integrity in the context of dysbiosis. Subsequently, we conclude that there is a research need to establish D-lactate as a minimally invasive biomarker in gastrointestinal diseases.

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Don't Forget To Test for D-Lactic Acid in Short Bowel Syndrome

Cited by 19 publications

References 6 publications

D-Lactic Acidosis: An Underrecognized Complication of Short Bowel Syndrome

D-Lactic Acidosis: An Underrecognized Complication of Short Bowel Syndrome

Clinical case and short review of extreme short bowel syndrome: an update 21 years after

D-Lactate: Implications for Gastrointestinal Diseases

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