Lactic acidosis: a review of 57 cases

Abstract

During the past 2 yr 58 episodes of lactic acidosis were observed. These were divided into 3 groups. The first comprised 13 patients (23%) in whom the anion gap increase was wholly due to lactate ion. Circulatory collapse and anoxia were present in nearly half of these patients, while in the remainder reticulosis, diabetic hyperglycaemia, phenformin therapy, liver disease or ethanol intoxication were present. The second group consisted of 17 patients (29%) in whom at least half the anion gap increase was due to lactate ion. Most of these patients were receiving phenformin. The third group of patients numbered 28 (48%) and had increased anion gaps of which less than half was due to lactate ion. Diabetic hyperglycaemia with ketosis was observed in half of these patients, whilst the remainder were receiving phenformin or were in circulatory collapse. There was a high incidence of renal impairment and liver disease, in addition to diabetes mellitus, in these patients developing lactic acidosis.