Lactic acidosis with hypoglycemia and hyperammonemia observed in two uremic patients during calcium calcium hopantenate treatment.

Abstract

Calcium hopantenate (HOPA), a drug for treating symptoms of cerebrovascular disease, is a derivative of gamma-aminobutyric acid and is also an analog of pantothenic acid. It is speculated that calcium hopantenate may affect lactate generation, glucose metabolism, and ammoniadisposal through the inhibition of pantothenic acid metabolism. Wereport two uremic patients with complaints of consciousness disturbance with lactic acidosis, hypoglycemia and hyperammonemia.HOPA is mainly excreted with urine. Severe accumulation of HOPA, documentedat the onset of unconsciousness in our uremic cases, might be responsible for marked inhibition of pantothenic acid metabolism.