Lactic acidosis in a diabetic treated with buformin

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  • ブホルミンによる重篤な乳酸アシドーシスの１症例

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Lactic acidosis in diabetics on biguanide therapy is rare but associated with poor prognosis. We report here a case of buformin-associated lactic acidosis successfully treated with hemodialysis (HD) and continuous hemodiafiltration (CHDF). A 49-year-old man with diabetes mellitus presented himself to the emergency room complaining of abdominal pain and general fatigue. He had begun taking buformin three days before. Initial investigations revealed severe hyperkalemia (K+9.1mmol·l-1) and lactic acidosis (pH6.84, BE-31.5mmol·l-1, Lactate 18.2mmol·l-1). He was transferred to the ICU where he underwent two sessions of HD and CHDF. On the third hospital day the patient's condition stabilized and CHDF was discontinued. He was discharged from the ICU on the 6th hospital day. We suggest that hemopurification is the treatment of choice for buformin-associated lactic acidosis, since it not only corrects acid-base disorders, but also may remove buformin.

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