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Related Experiment Videos

D-lactic acidosis: pathologic consequence of saprophytism

A Vella1, G Farrugia

  • 1Department of Internal Medicine, Mayo Clinic Rochester, Minnesota 55905, USA.

Mayo Clinic Proceedings
|May 15, 1998
PubMed
Summary

D-Lactic acidosis, a dangerous condition in short bowel patients, arises from abnormal gut bacteria overproducing D-lactate. Prompt diagnosis and treatment are crucial for managing this potentially fatal metabolic disorder.

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Area of Science:

  • Clinical Medicine
  • Gastroenterology
  • Metabolic Disorders

Background:

  • Short bowel syndrome (SBS) can lead to complex metabolic disturbances.
  • Intestinal flora plays a significant role in host metabolism.
  • D-Lactic acidosis is a rare but serious complication associated with SBS.

Observation:

  • A 50-year-old woman with SBS presented with recurrent neurological symptoms including weakness, ataxia, slurred speech, confusion, and nausea.
  • Diagnostic evaluation revealed markedly elevated blood D-lactate levels (8.2 mmol/L) during an episode of confusion.
  • The patient's condition was attributed to D-lactic acidosis.

Findings:

  • D-Lactic acidosis results from excessive D-lactate production by abnormal intestinal microflora in patients with a shortened small intestine and an intact colon.

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  • The overproduced D-lactate overwhelms the body's metabolic capacity, leading to its accumulation in the blood.
  • This case highlights the direct link between altered gut microbiota and the manifestation of disease.

    • Implications:

    • Increased clinical awareness of D-lactic acidosis is essential for timely diagnosis and effective management.
    • Understanding the pathophysiology of D-lactic acidosis offers insights into the metabolic functions of the gut microbiome.
    • This condition underscores the importance of considering microbial dysbiosis in unexplained metabolic and neurological symptoms in SBS patients.