[Dietetic treatment with fructose in a 5-year-old girl with recurrent D-lactic acidosis]

Nutr Hosp. 2018 Mar 1;35(2):495-498. doi: 10.20960/nh.1453.
[Article in Spanish]

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Acidosis, Lactic / diet therapy*
  • Child, Preschool
  • Diet, Carbohydrate-Restricted
  • Enteral Nutrition
  • Female
  • Fructose / therapeutic use*
  • Humans
  • Lactic Acid
  • Short Bowel Syndrome / complications
  • Short Bowel Syndrome / diet therapy
  • Treatment Outcome

Substances

  • Fructose
  • Lactic Acid