Lactic acidosis with hypoglycemia and hyperammonemia observed in two uremic patients during calcium calcium hopantenate treatment.

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  • OTSUKA Masakazu
    Department of Internal Medicine, Tokyo Medical and Dental University
  • AKIBA Takashi
    Department of Internal Medicine, Tokyo Medical and Dental University
  • OKITA Yoshiko
    Department of Internal Medicine, Tokyo Medical and Dental University
  • TOMITA Kimio
    Department of Internal Medicine, Tokyo Medical and Dental University
  • YOSHIYAMA Naoki
    Department of Internal Medicine, Tokyo Medical and Dental University
  • SASAOKA Takuo
    Department of Internal Medicine, Yokosuka Mutual Hospital
  • KANAYAMA Masaaki
    Department of Internal Medicine, Yokosuka Mutual Hospital
  • MARUMO Fumiaki
    Department of Internal Medicine, Tokyo Medical and Dental University

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説明

Calcium hopantenate (HOPA), a drug for treating symptoms of cerebrovascular disease, is a derivative of gamma-amino butyric acid and is also an analog of pantothenic acid. It is speculated that calcium hopantenate may affect lactate generation, glucose metabolism, and ammonia disposal through the inhibition of pantothenic acid metabolism. We report two uremic patients with complaints of consciousness disturbance with lactic acidosis, hypoglycemia and hyperammonemia. HOPA is mainly excreted with urine. Severe accumulation of HOPA, documented at the onset of unconsciousness in our uremic cases, might be responsible for marked inhibition of pantothenic acid metabolism.

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