Early introduction of hemodialysis for metformin-induced lactic acidosis : A case report
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- Ogawa Naoko
- Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center
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- Tsurukiri Junya
- Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center
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- Sano Hidefumi
- Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center
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- Numata Jushi
- Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center
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- Nagura Takeo
- Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center
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- Moriya Mariko
- Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center
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- Oda Jun
- Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine
Bibliographic Information
- Other Title
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- メトホルミン過量服薬による乳酸アシドーシスに対して早期の血液透析導入が有用であった1例
- メトホルミン カリョウ フクヤク ニ ヨル ニュウサン アシドーシス ニ タイシテ ソウキ ノ ケツエキ トウセキ ドウニュウ ガ ユウヨウ デ アッタ 1レイ
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Abstract
<p>Metformin-associated lactic acidosis is a life-threatening condition characterized by an elevation in serum lactate level in patients with metformin exposure. Here we report a case of lactic acidosis due to metformin overdose, who underwent early introduction of intermittent hemodialysis and successful clinical improvement. An adult patient who had treated diabetes was transferred to our emergency center because of metformin overdose 8 hours before. The patient took a total 54.5 g of metformin and 7.5 mg of repaglinide, and lactic acidosis (pH of 7.299 and lactate levels of 10.4 mmol/L) was determined on hospital arrival. Renal dysfunction and hyperkalemia were also determined and we diagnosed the patient as lactic acidosis caused by metformin overuse. After hospital admission, lactate was continuously increased and we decided to introduce intermittent dialysis 6 hours later on admission because we concerned the exacerbation of lactic acidosis caused by metformin overuse. Successful clinical improvement of the patient was observed because of two times of intermittent dialysis. We concluded that early introduction of intermittent dialysis should be considered as one of the treatment options of lactic acidosis caused by metformin overuse.</p>
Journal
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- Japanese Journal of Clinical Toxicology
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Japanese Journal of Clinical Toxicology 36 (1), 27-31, 2023-03-10
Japanese Society for Clinical Toxicology
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Keywords
Details 詳細情報について
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- CRID
- 1390577065837061504
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- NII Book ID
- AN10064448
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- ISSN
- 27582140
- 09143777
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- NDL BIB ID
- 032745922
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
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- Abstract License Flag
- Allowed