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D-lactate encephalopathy.

J R Thurn, G L Pierpont, C W Ludvigsen

    The American Journal of Medicine
    |December 1, 1985
    PubMed
    Summary

    Elevated D-lactate levels, not from human metabolism, can cause acidosis after gut surgery. This study found D-lactate encephalopathy occurs in patients with jejunoileal bypass and other gastrointestinal disorders.

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    Area of Science:

    • Biochemistry
    • Gastroenterology
    • Neurology

    Background:

    • D-lactate is produced by intestinal bacteria, not human metabolism.
    • Absorption of bacterial D-lactate can lead to systemic acidosis, especially post-gastrointestinal surgery.
    • D-lactate encephalopathy is a potential complication in specific patient groups.

    Purpose of the Study:

    • To investigate the prevalence of D-lactate encephalopathy.
    • To determine D-lactate occurrence in various disorders.
    • To correlate serum D-lactate levels with clinical symptoms.

    Main Methods:

    • Serum D-lactate levels were measured in healthy volunteers, obese individuals, patients with jejunoileal bypass, and randomly selected hospitalized patients.
    • Clinical symptoms consistent with D-lactate encephalopathy were recorded.
    • D-lactate levels were monitored over time in some patients.

    Main Results:

    • D-lactate was undetectable in healthy and obese individuals (<0.5 mmol/liter).
    • In jejunoileal bypass patients, 9 out of 16 with symptoms had elevated D-lactate (>0.5 mmol/liter), with levels fluctuating.
    • Elevated D-lactate (>0.5 mmol/liter) was found in 2.8% of hospitalized patients, with 60% having a history of GI surgery or disease.

    Conclusions:

    • Elevated serum D-lactate is common in jejunoileal bypass patients and occurs in other GI disorders.
    • D-lactate encephalopathy symptoms are sensitive but not specific indicators.
    • Monitoring D-lactate levels is crucial for patients with specific gastrointestinal conditions.

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