Survival and Vision Restoration Following Severe Metformin-associated Metabolic Acidosis With Transient Blindness: A Case Report and Review of the Literature.

Autor:	Mikhail ES; Department of Internal Medicine, McLaren Health Care/Michigan State University, Flint, MI, USA., Jankowski M; Department of Internal Medicine, McLaren Health Care/Michigan State University, Flint, MI, USA., Alexander D; Department of Internal Medicine, McLaren Health Care/Michigan State University, Flint, MI, USA., Pandya D; Department of Pulmonary and Critical Care, McLaren Health Care/Michigan State University, Flint, MI, USA., Kunadi A; Department of Internal Medicine, McLaren Health Care/Michigan State University, Flint, MI, USA.
Jazyk:	angličtina
Zdroj:	Journal of community hospital internal medicine perspectives [J Community Hosp Intern Med Perspect] 2024 Mar 04; Vol. 14 (2), pp. 96-99. Date of Electronic Publication: 2024 Mar 04 (Print Publication: 2024).
DOI:	10.55729/2000-9666.1321
Abstrakt:	Metformin-associated lactic acidosis (MALA) is a life-threatening condition that may occur as a side effect of biguanides. This condition has a mortality rate of approximately 55 % depending on the severity. Typical symptoms include abdominal pain, nausea, vomiting, and diarrhea, but may also manifest with severe symptoms such as blindness, distributive shock, and renal failure requiring ICU level care. We present the case of a female in her early 70s who arrived at the emergency department with altered mental status and new-onset blindness, later diagnosed with severe acidosis (pH 6.607). She was intubated for hemodynamic instability and continuous renal replacement therapy (CRRT) was started to address her acid-base status. Her metformin concentration was found to be exceptionally high at 34 mcg/ml, significantly surpassing the normal range of 1-2 mcg/ml. Fortunately, the patient survived and was subsequently transferred to the medical floors in stable condition. Physicians should perform medication review and consider "MALA" as a potential etiology of severe acidosis when forming a differential diagnosis. Competing Interests: Conflict of interest: The authors have no conflicts of interest to disclose (© 2024 Greater Baltimore Medical Center.)
Databáze:	MEDLINE
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