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D-lactic acidosis.

Craig Petersen1

  • 1University of California, Davis, Medical Center, Sacramento, CA 95817, USA. twofunclub@aol.com

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|November 25, 2005
PubMed
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D-lactic acidosis, a rare neurologic syndrome, causes symptoms like confusion and ataxia after high-carbohydrate meals in patients with short bowel syndrome. This condition results from gut bacteria producing excess D-lactate, leading to metabolic acidosis.

Area of Science:

  • Neurology
  • Gastroenterology
  • Biochemistry

Background:

  • D-lactic acidosis (DLA) is a rare neurologic syndrome.
  • It is associated with short bowel syndrome or jejuno-ileal bypass surgery.
  • Symptoms manifest after high-carbohydrate intake.

Purpose of the Study:

  • To review the pathophysiology of D-lactate production and accumulation.
  • To explore factors contributing to DLA's neurologic manifestations.
  • To examine diagnostic and treatment methods for DLA.

Main Methods:

  • Literature review of D-lactic acidosis.
  • Analysis of pathophysiology, clinical presentation, diagnosis, and treatment.
  • Identification of areas for future research.

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Main Results:

  • Malabsorbed carbohydrates fermented by abnormal gut flora produce excess D-lactate.
  • Elevated D-lactate levels in circulation correlate with neurologic symptoms.
  • Neurologic symptoms include altered mental status, ataxia, and slurred speech.

Conclusions:

  • D-lactate accumulation is central to DLA, but its direct causal role in neurologic symptoms requires further investigation.
  • Understanding the interplay between gut microbiota, D-lactate, and neurologic function is crucial.
  • Further research is needed to clarify DLA's etiology and optimize management strategies.