TY - JOUR
T1 - d-Lactic acidosis in children
T2 - An unusualmetabolic complication of small bowel resection
AU - Perlmutter, David H.
AU - Boyle, John T.
AU - Campos, Joseph M.
AU - Egler, Joseph M.
AU - Watkins, John B.
N1 - Funding Information:
From the Divisions of Gastroenterology and Nutrition, and Endocrinology, and Microbiology Laboratory, The Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania School of Medicine. Presented in part at the Meeting of the Society for Pediatric Research, May 1982, and published in abstract form (Pediatr Res 16:173A, 1982). Supported by the National Institutes of Health, Grants 2 RO1 HD 13913 and 5 ROI HD 13932," and by the Cystic Fibrosis Foundation, Grant G251B. Reprint Address: David H. Perlmutter, M.D., Division of Gastroenterology and Nutrition, Children's Hospital Medical Center, 300 Longwood Ave., Boston, MA 02115.
PY - 1983/2
Y1 - 1983/2
N2 - Acidosis caused by intestinal bacterial d-lactate production occurs in ruminants engorged with carbohydrate. A similar phenomenon was identified in two children who developed recurrent episodes of metabolic acidosis and peculiar neurologic symptoms in response to increased dietary carbohydrate after major small bowel resections. Both children were found to have elevated plasma concentrations of d-lactic acid at the time of each episode. Acid base and neurologic abnormalities responded immediately to neomycin therapy. Among a number of microorganisms isolated from stool cultures of these patients, one anaerobic Lactobacillus acidophilus species produced large amounts of d-lactate in vitro. Reduction in carbohydrate intake in one patient tested led to a fall in d-lactate generation. We believe that excessive d-lactate production by intestinal bacteria, from malabsorbed carbohydrate, may produce metabolic acidosis and neurologic symptoms in children with small bowel resections.
AB - Acidosis caused by intestinal bacterial d-lactate production occurs in ruminants engorged with carbohydrate. A similar phenomenon was identified in two children who developed recurrent episodes of metabolic acidosis and peculiar neurologic symptoms in response to increased dietary carbohydrate after major small bowel resections. Both children were found to have elevated plasma concentrations of d-lactic acid at the time of each episode. Acid base and neurologic abnormalities responded immediately to neomycin therapy. Among a number of microorganisms isolated from stool cultures of these patients, one anaerobic Lactobacillus acidophilus species produced large amounts of d-lactate in vitro. Reduction in carbohydrate intake in one patient tested led to a fall in d-lactate generation. We believe that excessive d-lactate production by intestinal bacteria, from malabsorbed carbohydrate, may produce metabolic acidosis and neurologic symptoms in children with small bowel resections.
UR - http://www.scopus.com/inward/record.url?scp=0020661677&partnerID=8YFLogxK
U2 - 10.1016/S0022-3476(83)80527-7
DO - 10.1016/S0022-3476(83)80527-7
M3 - Article
C2 - 6822927
AN - SCOPUS:0020661677
SN - 0022-3476
VL - 102
SP - 234
EP - 238
JO - The Journal of Pediatrics
JF - The Journal of Pediatrics
IS - 2
ER -