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Clinical Chemistry 41: 107-110, 1995;
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Clinical Chemistry, Vol 41, 107-110, Copyright © 1995 by American Association for Clinical Chemistry

D-lactic acidemia and aciduria in pediatric and adult patients with short bowel syndrome

G Bongaerts, J Tolboom, T Naber, J Bakkeren, R Severijnen and H Willems
Department of Medical Microbiology, University Hospital Nijmegen St. Radboud, The Netherlands.

D-Lactate produced by abundant intestinal lactobacilli during acidotic episodes in short bowel (SB) patients is commonly regarded as a main factor in the pathogenesis of SB syndrome-associated (D-lactic) acidosis. Since we had observed that gram-positive bacteria, mainly lactobacilli, were abundant even in the absence of acidosis, we studied serum concentrations and urinary excretions of D- and L-lactate in young and adult SB patients, especially during nonacidotic periods. Serum L-lactate and urinary L-lactate excretion were similar in adults and children. Serum D-lactate and urinary D-lactate excretion were higher in SB children than in SB adults. Food consumption affects D- lactate production and alters D-lactic acidemia and aciduria. We conclude that D-lactate is frequently present in serum of SB patients even in the absence of acidosis. High serum concentrations and urinary excretions may reflect dietary factors in these patients.


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