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Colegio de Medicina Interna de México.

2010, Número 3

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Med Int Mex 2010; 26 (3)


Acidosis láctica por metformina

Carrillo ER, Sosa GJO

Idioma: Español
Referencias bibliográficas: 31
Paginas: 276-280
Archivo PDF: 176.33 Kb.


RESUMEN

Antecedentes: la acidosis láctica asociada con metformina tiene baja prevalencia y mortalidad de 30 a 50%.
Objetivo: comunicar un caso de acidosis láctica asociada con metformina y revisar los conceptos actuales y opciones terapéuticas de esta enfermedad.
Caso clínico: paciente de 75 años de edad con diabetes mellitus tipo 2 e insuficiencia renal en tratamiento con metformina. Ingresó por un cuadro caracterizado por diarrea, dificultad respiratoria, deshidratación, oliguria, alteraciones del estado de alerta, anemia, hipercalemia, hiperazoemia, acidosis láctica con concentraciones de lactato de 9.1 mmol/L. Se trató con medidas de apoyo, hemodiálisis y suspensión de la metformina, con evolución satisfactoria.
Conclusiones: la acidosis láctica secundaria a metformina debe sospecharse en los enfermos tratados con este medicamento y con factores de riesgo como insuficiencia renal y hepática, alcoholismo y sepsis. El diagnóstico temprano y tratamiento oportuno son fundamentales para disminuir su mortalidad.


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