| Lactic Acidosis in Children: Clinical and Laboratory Evaluation. |
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Woo Jung Kim, Yoo Jin Yang, Hee Jung Chung |
1Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea.
2Department of Pediatrics, National Health Insurance Corporation, Ilsan Hospital, Goyang, Korea. |
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| Abstract |
PURPOSE
Lactic acidosis is one of the most common forms of metabolic acidosis. It is hard to fine the cause of lactic acidosis, because in many cases the clinical features of this disorder are non-specific and overlap with those of other metabolic or non-metabolic diseases. In this report, we tried to identify the causes of lactic acidosis and classified them into four groups:primary and secondary lactic acidosis, neurodegenerative disorders and others. METHODS: We analyzed the clinical characteristics of 22 patients who had arterial blood lactate levels over 2.5 mmol/L. They visited Ilsan Hospital because of seizures or delayed development. Clinical characteristics include laboratory findings, EEG, brain imaging study, chromosomal study and metabolic enzymatic evaluation. RESULTS: The mean age of the patients was 3.4 years. Most of them complained of delayed development(21 cases) and seizures(14 cases). One of the patients was revealed as primary lactic acidosis, and the other one secondary lactic acidosis. Also, there was a case of neurodegenerative disease. Furthermore, the other ten patients were affected by other causes of lactic acidosis:7 cases of epilepsy, a case of Rett syndrome, a case of 4p deletion syndrome, and a case of cerebral palsy. However, the causes of lactic acidosis of the remaining 9 patients were unknown. But 5 of them were thought to be affected by respiratory chain disorders diagnosed by modified Walker's criteria. CONCLUSION: There are numerous disorders in children which can produce lactic acidosis. Although metabolic work-ups of these patients are very complex and require coordinated efforts of clinicians and laboratory works, early diagnosis of the etiologic nature of the disease is essential to minimize the progression and the complications of the disease. |
| Key Words:
Lactic acidosis, Mitochondrial disorders |
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