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Original Article
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Korean J Med. 2007;73(4):443-447.
- 증례 : 티아민 결핍에 의해 유발된 젖산산증 1예
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변승운.최성호.박현구.김범준.김의영.이규형.양원석, , , , , ,
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- A case of lactic acidosis caused by thiamine deficiency
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Seung Woon Byun, Seong-Ho Choi, Hyun-Gu Park, Beom-Jun Kim, Eui Young Kim, Kyoo-Hyung Lee, Won Seok Yang
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경희대학교 의과대학 순환기내과학교실
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- Abstract
- Lactic acidosis commonly occurs in association with shock. We encountered lactic acidosis in a patient with
normal blood pressure. The patient was a 17 year-old man with acute lymphocytic leukemia. He was admitted for
bone marrow transplantation. During hospitalization, he relied on total parenteral nutrition due to his poor oral
intake. On the 37th day after admission, he developed lactic acidosis without an episode of hypotension or any
causative medication. Because vitamins were not included in the parenteral nutrition, we prescribed thiamine
replacement, and this corrected the acidosis within a few hours.
Thiamine (in its active derivative) is a coenzyme for pyruvate dehydrogenase; thus, its deficiency causes
accumulation of pyruvate and lactate. This case suggests that thiamine deficiency should be included in a
differential diagnosis of lactic acidosis in patients who are on total parenteral nutrition without vitamin
supplementation.(Korean J Med 73:443-447, 2007)
Keywords :Lactic acidosis, Thiamine deficiency, Total parenteral nutrition
