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Recurrent 'Lactic' Acidosis-a Cautionary Tale.

P Kar¹, V Walker, P Sharp

¹Specialist Registrar in Diabetes and Endocrinology Southampton General Hospital Tremona Road Southampton SO16 6YD.

|May 26, 2011

Summary

This summary is machine-generated.

Recurrent lactic acidosis may indicate ethylene glycol poisoning. Glycolic acid, a metabolite, can be falsely measured as lactic acid by some analyzers, complicating diagnosis. Increased awareness is crucial for accurate patient management.

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Measurement and Analysis of Extracellular Acid Production to Determine Glycolytic Rate

Measurement and Analysis of Extracellular Acid Production to Determine Glycolytic Rate

Published on: December 12, 2015

Area of Science:

Toxicology
Clinical Chemistry
Internal Medicine

Background:

Lactic acidosis is a serious condition with diverse causes.
Ethylene glycol poisoning is a known but less common cause of metabolic acidosis.
Point-of-care analyzers are widely used for rapid diagnostic testing.

Purpose of the Study:

To report a case of recurrent lactic acidosis misdiagnosed due to ethylene glycol poisoning.
To highlight the issue of spurious lactic acid measurement caused by glycolic acid.
To increase awareness among clinicians about this diagnostic challenge.

Main Methods:

Case presentation of a patient with recurrent 'lactic' acidosis.
Review of relevant medical literature on ethylene glycol poisoning and metabolic acidosis.
Discussion of analytical interferences in point-of-care testing.

Main Results:

The patient's recurrent acidosis was ultimately attributed to ethylene glycol poisoning.
Glycolic acid, a metabolite of ethylene glycol, can interfere with lactic acid assays on certain analyzers.
This interference can lead to misdiagnosis and delayed treatment.

Conclusions:

Ethylene glycol poisoning should be considered in cases of unexplained or recurrent lactic acidosis.
Clinicians must be aware of potential analytical interferences, such as glycolic acid mimicking lactic acid.
Enhanced diagnostic vigilance is necessary for managing complex metabolic acidosis cases.