Geetinder Chattha, MD; Allen I. Arieff, MD; Cary Cummings, MD; Lawrence M. Tierney Jr., MD
Lactic acidosis has been reported in patients with the acquired immunodeficiency syndrome (AIDS) only in association with tissue hypoxia. From 1989 to 1991, seven patients with human immunodeficiency virus (HIV) infection who had lactic acidosis without obvious cause were evaluated. Nine normovolemic patients without acidosis or hypoxia served as controls. Findings in the patients included the following: pH, 7.22 ± 0.07; bicarbonate, 7.0 ± 2.4 mmol/L; and lactate, 14.3 ± 2.6 mmol/L. Patients and controls did not differ regarding cardiac index, PO2, oxygen extraction ratio, and systemic oxygen delivery or utilization. Four patients with AIDS died of overwhelming metabolic acidosis, but the three other patients were discharged from the hospital. Autopsy in the four patients who died showed no obvious cause for lactic acidosis. The normal oxygen delivery, utilization, and extraction suggest that increased hyperlactatemia occurred for reasons other than hypoxia. Thus, patients with AIDS but without hypoxia can develop severe lactic acidosis that is not necessarily fatal.
Chattha G, Arieff AI, Cummings C, Tierney LM. Lactic Acidosis Complicating the Acquired Immunodeficiency Syndrome. Ann Intern Med. ;118:37–39. doi: 10.7326/0003-4819-118-1-199301010-00007
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Published: Ann Intern Med. 1993;118(1):37-39.
Endocrine and Metabolism, HIV, Infectious Disease, Prevention/Screening.
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