Abstract

TRAVIESO-SUAREZ, Lourdes; FRAILE, Pilar Quijada  and  GINER, Consuelo Pedrón. Dietetic treatment with fructose in a 5-year-old girl with recurrent D-lactic acidosis. Nutr. Hosp. [online]. 2018, vol.35, n.2, pp.495-498. ISSN 1699-5198.  https://dx.doi.org/10.20960/nh.1453.

D-lactic acidosis is an infrequent complication, mainly reported in patients with short bowel syndrome. It is characterized by recurrent episodes of encephalopathy with elevated serum D-lactic acid, usually associating metabolic acidosis. The presence of D-lactate-producing bacteria is necessary for the development of this complication. Other factors, such as the ingestion of large amounts of carbohydrates or reduced intestinal motility, contribute to D-lactic acidosis. We report a case of recurrent D-lactic acidosis in a 5-year-old girl with short bowel syndrome, due to a midgut volvulus. She initially received oral antibiotics in order to treat bacterial overgrowth, together with oral carbohydrates restriction. Nevertheless, recurrences did occur. Subsequently, 25% of the enteral nutrition was replaced for a formula containing fructose exclusively, while other fermentable sugars were restricted from the diet. After 16 years of follow up, further recurrences of D-lactic acidosis were not observed.

Keywords : D-lactic acidosis; D-lactate; Short bowel.

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