Lactic Acidosis in Paediatrics: Clinical and Laboratory Evaluation

Stern, Harry A.

doi:10.1177/000456329403100502

Cited by 22 publications

(13 citation statements)

References 40 publications

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“…An increased level of lactate is often found in neonates as a result of hypoxia, low blood perfusion, hepatic or renal failure, high glucose intake and also in children with various inherited metabolic disorders [22,23]. The parameters of acidobasic balance are insufficient to confirm metabolic disturbances and hyperlactacidemia in children, because the lactate level in blood neither correlates with pH nor with base excess values [24].…”

Section: Discussionmentioning

confidence: 99%

Mitochondrial Energy Metabolism in Very Premature Neonates

et al. 2002

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The activity, amount and protein composition of pyruvate dehydrogenase (PDH) and respiratory chain complexes were studied in muscle mitochondria obtained postmortally from 6 neonates with a gestational age of 23–29 weeks. The activities of PDH and respiratory chain complex III and IV and citrate synthase were significantly lower in comparison with control children aged 0.5–2 and 2–20 years. Protein analyses revealed a parallel decrease in the content of PDH, respiratory chain complexes and their subunits in the cases analyzed. The observed immaturity of the mitochondrial energy-providing system suggests that significant development of mitochondrial energy metabolism occurs during the last 3 months of prenatal development. The metabolic disturbances of mitochondrial energy conversion associated with the low functional capacity and content of PDH and respiratory chain complexes may play an important role in the morbidity of very premature neonates.

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Section: Discussionmentioning

confidence: 99%

Mitochondrial Energy Metabolism in Very Premature Neonates

et al. 2002

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“…In tumour cells it has been shown to promote synthesis and release of urokinase plasminogen activator.6 It is also an important mitogen to normal cells such as fibroblasts and smooth muscle cells that play a key role in atherogenesis.7 Thrombin is also mitogenic to tumour cells, potentiating the proliferative response to insulin, epidermal growth factor, and transferrin. 8 Other activated serine proteases generated as a result of the activation of coagulation have roles outside normal haemostasis and are mitogenic. Of particular interest is factor Xa, the factor occupying the pivotal position in the normal coagulation pathway.…”

Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) of the brain was performed after the first stroke-like episode and showed increased signal intensity in T2 weighted images in the left temporal and parieto-occipital areas. The deproteinated blood lactate concentration was 4-8 mmol/l (normal: 0-5-1 3 mmol/1) and pyruvate was 188 Htmol/l (normal: 45-80 gmol/l), with a lactate/pyruvate ratio of 25-5 (normal: [6][7][8][9][10][11][12][13][14]. The results of all other serum laboratory tests were normal.…”

mentioning

confidence: 99%

Diagnosis of mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes in a Chinese family by PCR/restriction enzyme analysis

Lam¹,

Jain²,

Chan³

et al. 1995

Molecular Pathology

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The clinical presentation and the biochemical and molecular genetic findings are described in a 13 year old Chinese boy with MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes). The diagnosis was initially suspected because of the characteristic clinical features and the strong family history of convulsions. Using polymerase chain reaction-restriction enzyme analysis, the heteroplasmic nt3243 A-G mutation in mtDNA of peripheral blood leucocytes and a muscle sample was demonstrated. The oligosymptomatic relatives were then screened by this method and the degree of heteroplasmy was analysed. This appears to be the first report of a MELAS family in Hong Kong with this described mutation. Molecular genetic techniques are advantageous in the diagnosis of MELAS.

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“…An elevated baseline level of serum lactate may occur if • the forearm muscles are contracted while the baseline sample is taken. Mitochondrial disorders myopathies may be associated • with elevated baseline lactate [ 14 ] , as may numerous other toxic and metabolic disorders [ 5,23 ] . An elevated baseline serum ammonia level may be due to • medications such as valproic acid, smoking, and undue exertion prior to the test [ 24 ] .…”

Section: Abnormal Patternsmentioning

confidence: 99%