Metformin-Associated Lactic Acidosis following Intentional Overdose Successfully Treated with Tris-Hydroxymethyl Aminomethane and Renal Replacement Therapy

A 43-year-old woman was brought to the hospital with severe metabolic acidosis (pH 6.56, bicarbonate 3 mmol/L, and lactate 18.4 mmol/L) and a serum creatinine of 162 μmol/L with a serum potassium of 7.8 mmol/L. A delayed diagnosis of metformin-associated lactic acidosis was made, and she was treated...

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Main Authors: Ngan Lam, Gurbir Sekhon, Andrew A. House
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Case Reports in Nephrology
Online Access:http://dx.doi.org/10.1155/2012/671595
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author Ngan Lam
Gurbir Sekhon
Andrew A. House
author_facet Ngan Lam
Gurbir Sekhon
Andrew A. House
author_sort Ngan Lam
collection DOAJ
description A 43-year-old woman was brought to the hospital with severe metabolic acidosis (pH 6.56, bicarbonate 3 mmol/L, and lactate 18.4 mmol/L) and a serum creatinine of 162 μmol/L with a serum potassium of 7.8 mmol/L. A delayed diagnosis of metformin-associated lactic acidosis was made, and she was treated with tris-hydroxymethyl aminomethane (THAM) and renal replacement therapy (RRT). Following a complete recovery, she admitted to ingesting 180 tablets (90 grams) of metformin. Her peak serum metformin concentration was 170 μg/mL (therapeutic range 1-2 μg/mL). Our case demonstrates an intentional metformin overdose resulting in lactic acidosis in a nondiabetic patient who was successfully treated with THAM and RRT.
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series Case Reports in Nephrology
spelling doaj-art-d2e22d90a4754f1bb08ed43ce1f5a8712025-08-20T02:19:51ZengWileyCase Reports in Nephrology2090-66412090-665X2012-01-01201210.1155/2012/671595671595Metformin-Associated Lactic Acidosis following Intentional Overdose Successfully Treated with Tris-Hydroxymethyl Aminomethane and Renal Replacement TherapyNgan Lam0Gurbir Sekhon1Andrew A. House2Division of Nephrology, Department of Medicine, Western University, London, ON, N6A 3K7, CanadaDepartment of Medicine, Western University, London, ON, N6A 3K7, CanadaDivision of Nephrology, Department of Medicine, Western University, London, ON, N6A 3K7, CanadaA 43-year-old woman was brought to the hospital with severe metabolic acidosis (pH 6.56, bicarbonate 3 mmol/L, and lactate 18.4 mmol/L) and a serum creatinine of 162 μmol/L with a serum potassium of 7.8 mmol/L. A delayed diagnosis of metformin-associated lactic acidosis was made, and she was treated with tris-hydroxymethyl aminomethane (THAM) and renal replacement therapy (RRT). Following a complete recovery, she admitted to ingesting 180 tablets (90 grams) of metformin. Her peak serum metformin concentration was 170 μg/mL (therapeutic range 1-2 μg/mL). Our case demonstrates an intentional metformin overdose resulting in lactic acidosis in a nondiabetic patient who was successfully treated with THAM and RRT.http://dx.doi.org/10.1155/2012/671595
spellingShingle Ngan Lam
Gurbir Sekhon
Andrew A. House
Metformin-Associated Lactic Acidosis following Intentional Overdose Successfully Treated with Tris-Hydroxymethyl Aminomethane and Renal Replacement Therapy
Case Reports in Nephrology
title Metformin-Associated Lactic Acidosis following Intentional Overdose Successfully Treated with Tris-Hydroxymethyl Aminomethane and Renal Replacement Therapy
title_full Metformin-Associated Lactic Acidosis following Intentional Overdose Successfully Treated with Tris-Hydroxymethyl Aminomethane and Renal Replacement Therapy
title_fullStr Metformin-Associated Lactic Acidosis following Intentional Overdose Successfully Treated with Tris-Hydroxymethyl Aminomethane and Renal Replacement Therapy
title_full_unstemmed Metformin-Associated Lactic Acidosis following Intentional Overdose Successfully Treated with Tris-Hydroxymethyl Aminomethane and Renal Replacement Therapy
title_short Metformin-Associated Lactic Acidosis following Intentional Overdose Successfully Treated with Tris-Hydroxymethyl Aminomethane and Renal Replacement Therapy
title_sort metformin associated lactic acidosis following intentional overdose successfully treated with tris hydroxymethyl aminomethane and renal replacement therapy
url http://dx.doi.org/10.1155/2012/671595
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