A case of lactic acidosis caused by thiamine deficiency.
- Author:
Seung Woon BYUN
1
;
Seong Ho CHOI
;
Hyun Gu PARK
;
Beom Jun KIM
;
Eui Young KIM
;
Kyoo Hyung LEE
;
Won Seok YANG
Author Information
1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. wsyang@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Lactic acidosis;
Thiamine deficiency;
Total parenteral nutrition
- MeSH:
Acidosis;
Acidosis, Lactic*;
Adolescent;
Blood Pressure;
Bone Marrow Transplantation;
Diagnosis, Differential;
Hospitalization;
Humans;
Hypotension;
Lactic Acid;
Oxidoreductases;
Parenteral Nutrition;
Parenteral Nutrition, Total;
Precursor Cell Lymphoblastic Leukemia-Lymphoma;
Pyruvic Acid;
Shock;
Thiamine Deficiency*;
Thiamine*;
Vitamins
- From:Korean Journal of Medicine
2007;73(4):443-447
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Lactic acidosis commonly occurs in association with shock. We encountered lactic acidosis in a patient with normal blood pressure. The patient was a 17 year-old man with acute lymphocytic leukemia. He was admitted for bone marrow transplantation. During hospitalization, he relied on total parenteral nutrition due to his poor oral intake. On the 37th day after admission, he developed lactic acidosis without an episode of hypotension or any causative medication. Because vitamins were not included in the parenteral nutrition, we prescribed thiamine replacement, and this corrected the acidosis within a few hours. Thiamine (in its active derivative) is a coenzyme for pyruvate dehydrogenase; thus, its deficiency causes accumulation of pyruvate and lactate. This case suggests that thiamine deficiency should be included in a differential diagnosis of lactic acidosis in patients who are on total parenteral nutrition without vitamin supplementation.
