İlker AKBAŞ, Caner AKUFUK, Muhammet Mustafa YILMAZ, Atilla Eren KURT, Fatih COŞKUN

A Case Report of Metformin Related Lactic Acidosis

Metformin is an oral antidiabetic drug of the biguanide classused in type 2 diabetic patients with normal renal function. The mortality rate is high in cases of lactic acidos is developing in metformin intoxication. In the emergency department, metformin intoxication should be considered in the differential diagnosis of patients whouse metformin and have high anion gap metabolic acidosis (lactic acidosis). The most important and effective treatment with early diagnosis is correction of metabolic acidosis with hemodialysis or hemofiltration methods, bicarbonate treatment, adjustment of blood glucose level. Cardiovascular system support therapy significantly reduces morbidity/mortality. In this case report, we present the early diagnosis and successful treatment of a patient with lactic acidosis due to metformin intoxication.

Keywords:

Metformin, Poisoning, Lactic acidosis,

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Çakmak F. Demographic Characteristics of Patients Applied to The Emergency Service with Drug Intoxications. Eurasian Journal of Toxicology. 2020; 2(3): 68-70.
Balkan, B. , Demir, G. , Balkan, F. , Çetingök, H. &Atiç, E. (2020). Metformin İlişkili Laktik Asidoz; Bir Olgu Nedeni İle Literatürün Gözden Geçirilmesi. Tıp Fakültesi Klinikleri Dergisi. 3 (1) , 49-53 .
Çağla Patır, D. , Köseli, İ. , Engin, B. & Akar, H. (2019). Metformin intoksikasyonuna bağlı gelişen nadir bir birliktelik şiddetli laktik asidoz ve akut pankreatit: Olgu sunumu . İstanbul Bilim Üniversitesi Florence Nightingale Tıp Dergisi , 4 (4) , 197-199 .
Aydar, H. , Tezcan, N. & Mutluay, R. (2022). Metformin intoksikasyonuna sekonder gelişen akut böbrek hasarı ve laktik asidoz . Pamukkale Medical Journal , 15 (2) , 379-382 . DOI: 10.31362/patd.900939
Eren, E. , Türe, M. , Almaz, V. , Bilgiç, T. , Yıldırım, İ. & Gider, T. (2012). Bir ergende metformin zehirlenmesi . Türk Pediatri Arşivi , 47 (4) , 313-314 . DOI: 10.4274/tpa.1004
Çelebi K., Ahmet Ö. Acute Renal Failure Due to Metformin Intoxication: Case Report. J Turk Soc Intensive Care. 2018; 16: 76-78
Gedik M. S. , Hakkoymaz H. , Kilci A. İ. , Küçük Ö. F. General Approach to Cases of Drug Intoxication. Eurasian Journal of Critical Care. 2023; 5(1): 17-21.
Sener K, Arslan B, Ozselcuk S, Guven R. Resistant Lactic Acidemia Due to Accidental Cheese Starter Culture Ingestion. American Journal of Emergency Medicine. 2022;60: 228.e1-228.e2
Wills BK., Bryant SM., Buckley P., Seo B. Can acute over dose of metformin lead to lactic acidosis? Am J EmergMed. 2010; 28: 857-861.
Li Cavoli G.,Tortorici C., Bono L., Giammarresi C., Ferrantelli A., Zagarrigo C., et al. Acute kidney injury associated with metformin. Am J EmergMed. 2011; 29: 568-569.
Mustafa E., Lai L., Lien YH. Rapid recovery from acute kidney injury in a patient with metformin-associated lactic acidosis and hypothermia. Am J Med. 2012; 125: 1-2.
Acquistapace G., Rossi M., Garbi M., Cosci P., Canetta C., Manelli A., et al. Acute metformin intoxication: 2012 experience of Emergency Departement of Lodi, Italy. Clin Chem Lab Med. 2014; 52: 1489-97.