Lactic acidosis
| Lactic acidosis | |
|---|---|
 |
|
| L-(+)-lactic acid | |
| Classification and external resources | |
| Specialty | endocrinology |
| ICD-10 | E87.2 |
| ICD-9-CM | 276.2 |
| DiseasesDB | 29145 |
| MedlinePlus | 000391 |
| eMedicine | article/768159 |
| MeSH | D000140 |
Lactic acidosis is a medical condition characterized by the buildup of lactate (especially L-lactate) in the body, with as a result an excessively low pH. It is a subtype of metabolic acidosis, where excessive acid is due to a problem with the body's metabolism.
Lactic acidosis is typically the result of an underlying acute or chronic medical condition, medication, or poisoning. The symptoms are generally attributable to these underlying causes, but may include nausea, vomiting, rapid deep breathing, and generalised weakness.
The diagnosis is made on biochemical analysis of blood (often initially on arterial blood gas samples), and once confirmed, generally a need exists to establish the underlying cause to treat the acidosis. In some situations, hemofiltration (purification of the blood) is temporarily required. In rare chronic forms of lactic acidosis caused by , a specific diet or dichloroacetate may be used. The prognosis of lactic acidosis depends largely on the underlying cause; in some situations (such as severe infections), it indicates an increased risk of death.
Lactic acidosis is commonly found in people who are unwell, such as those facing severe heart and/or lung disease, a severe infection with sepsis, the systemic inflammatory response syndrome due to another cause, severe physical trauma, or severe depletion of body fluids. Symptoms in humans include all those of typical metabolic acidosis (nausea, vomiting, generalized muscle weakness, and rapid breathing).
The several different causes of lactic acidosis include:
Most cells in the body normally metabolize glucose to form water and carbon dioxide in a two-step process. First, glucose is broken down to pyruvate through glycolysis. Then, oxidize the pyruvate into water and carbon dioxide by means of the Krebs cycle and oxidative phosphorylation. This second step requires oxygen. The net result is ATP, the energy carrier used by the cell for metabolic activities and to perform work, such as muscle contraction. When the energy in ATP is used during cell work via ATP hydrolysis, hydrogen ions, (positively charged protons) are released. The mitochondria normally incorporate these free hydrogen nuclei back into ATP, thus preventing buildup of unbound hydrogen cations, and maintaining neutral pH.
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