Abstract

Van Huffel L1MD, Benoit D2 MD PhD and Van Biesen W3 MD PhD

Lactic acidosis is a severe condition with a high mortality rate. We report a case of near-fatal lactic acidosis, secondary to an acute kidney injury in a patient on chronic treatment with metformin. In this case, fast recognition and adequate treatment of the entity lead to rapid recovery of the patient. The differences in presentation of type A and type B lactic acidosis are emphasized, because of the importance for treatment and prognosis. Considerations and new insights in the mechanism of Metformin Associated Lactic Acidosis(MALA) are discussed.With this case report we want to point out the aspects one should consider when treating or stop treating a patient with metformin and nuance the fear for MALA.