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短肠综合征继发的D-乳酸酸中毒

[D-Lactic acidosis secondary to short bowel syndrome].

作者信息

Tapia Guerrero M J, Olveira G, Bravo Utrera M, Colomo Rodríguez N, Fernández García J C

机构信息

Unidad de Nutrición Clínica y Dietética, Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Málaga, Spain.

出版信息

Nutr Hosp. 2010 Sep-Oct;25(5):864-6.

Abstract

The short bowel syndrome appears for the reduction of intestinal absorptive surface due to functional or anatomical loss of part of the small bowel. We present the case of a 35-year-old woman with severe short bowel syndrome secondary to acute intestinal ischemia in adults, who presented at 5 years of evolution episodes of dizziness with gait instability and loss of strength in hands. The diagnosis was D-lactic acidosis. D-lactic acidosis is a rare complication, but important for their symptoms, of this syndrome. It is due to a change in intestinal flora secondary to an overgrowth of lactic acid bacteria that produce D-lactate. D-lactic acidosis should be looked for in cases of metabolic acidosis in which the identity of acidosis is not apparent, neurological manifestations without focality and the patient has short bowel syndrome or patients who have had jejunoileal bypass surgery. Appropriate treatment usually results in resolution of neurologic symptoms and prevents or reduces further recurrences.

摘要

短肠综合征是由于部分小肠出现功能性或解剖性缺失,导致肠道吸收面积减少。我们报告一例35岁成年女性,因急性肠缺血继发严重短肠综合征,病程5年时出现头晕、步态不稳及手部无力发作。诊断为D-乳酸性酸中毒。D-乳酸性酸中毒是该综合征一种罕见但因症状而重要的并发症。它是由产生D-乳酸的乳酸菌过度生长继发肠道菌群改变所致。在代谢性酸中毒病因不明、无局灶性神经表现且患者患有短肠综合征或曾行空肠回肠旁路手术的情况下,应考虑D-乳酸性酸中毒。适当治疗通常可使神经症状缓解,并预防或减少进一步复发。

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