Metformin-Associated Lactic Acidosis following Intentional Overdose Successfully Treated with Tris-Hydroxymethyl Aminomethane and Renal Replacement Therapy. (5th July 2012)

• Record Type: Journal Article
• Authors: Lam, Ngan; Sekhon, Gurbir; House, Andrew A.
• Other Names: Fujigaki Y. Academic Editor.; Packham D. Academic Editor.; Papagianni A. Academic Editor.; Schiffl H. Academic Editor.
• Is Part Of: Case reports in nephrology. Volume 2012(2012)
• Publication Date: 2012-07-05
• Subjects: Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrology; Kidneys -- Diseases; Nephrology; Periodicals; Electronic journals; Periodicals; 616.61
• DOI: 10.1155/2012/671595
• Languages: English
• ISSNs: 2090-6641

Abstract

Abstract : A 43-year-old woman was brought to the hospital with severe metabolic acidosis (pH 6.56, bicarbonate 3 mmol/L, and lactate 18.4 mmol/L) and a serum creatinine of 162 μ mol/L with a serum potassium of 7.8 mmol/L. A delayed diagnosis of metformin-associated lactic acidosis was made, and she was treated with tris-hydroxymethyl aminomethane (THAM) and renal replacement therapy (RRT). Following a complete recovery, she admitted to ingesting 180 tablets (90 grams) of metformin. Her peak serum metformin concentration was 170 μ g/mL (therapeutic range 1-2 μ g/mL). Our case demonstrates an intentional metformin overdose resulting in lactic acidosis in a nondiabetic patient who was successfully treated with THAM and RRT.