A fatal case of metformin-associated lactic acidosis

Toshikazu Ozeki, Rui Kawato, Mitsuru Watanabe, Shun Minatoguchi, Yukari Murai, Akihiro Ryuge, Koji Takasugi, Takuya Hamada, Yukako Oyama, Atsushi Nomura, Tatsuhito Tomino, Hideaki Shimizu, Yoshiro Fujita

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Abstract

A 72-year-old woman with a history of type 2 diabetes mellitus was brought to the ER with metforminassociated lactic acidosis. She received continuous hemofiltration and hemodialysis, but the laboratory analyses showed no improvement. She died 11 hours after admission. Metformin is minimally bound to proteins and is readily dialyzable, but a prolonged period of dialysis is required, because metformin has a very large distribution volume and is distributed to multiple compartments. The peak blood metformin level was 432 mg/L in this case, which is one of the highest metformin concentrations ever reported, and eight hours of hemodialysis were not sufficient to reduce the serum level.

Original languageEnglish
Pages (from-to)775-778
Number of pages4
JournalInternal Medicine
Volume55
Issue number7
DOIs
Publication statusPublished - 01-04-2016

All Science Journal Classification (ASJC) codes

  • Internal Medicine

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    Ozeki, T., Kawato, R., Watanabe, M., Minatoguchi, S., Murai, Y., Ryuge, A., Takasugi, K., Hamada, T., Oyama, Y., Nomura, A., Tomino, T., Shimizu, H., & Fujita, Y. (2016). A fatal case of metformin-associated lactic acidosis. Internal Medicine, 55(7), 775-778. https://doi.org/10.2169/internalmedicine.55.5415