Severe Lactic Acidosis in a Critically Ill Child: Think About Thiamine! A Case Report

Abstract In this article, we presented a teenager, in maintenance chemotherapy for leukemia, who was admitted for digestive symptoms related to a parasitic infection and required nutritional support with parenteral nutrition. After 6 weeks, his condition worsened with refractory shock of presumed se...

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Bibliographic Details
Published inJournal of pediatric intensive care Vol. 10; no. 4; pp. 307 - 310
Main Authors Didisheim, Clémence, Ballhausen, Diana, Choucair, Marie-Louise, Longchamp, David, Natterer, Julia, Ferry, Thomas, Perez, Marie-Hélène, Amiet, Vivianne
Format Journal Article
LanguageEnglish
Published Rüdigerstraße 14, 70469 Stuttgart, Germany Georg Thieme Verlag KG 01.12.2021
Subjects
Case Report
lactic acidosis
thiamine deficiency
critically ill child
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Summary:Abstract In this article, we presented a teenager, in maintenance chemotherapy for leukemia, who was admitted for digestive symptoms related to a parasitic infection and required nutritional support with parenteral nutrition. After 6 weeks, his condition worsened with refractory shock of presumed septic origin, necessitating extracorporeal membrane oxygenation. Despite hemodynamic stabilization, his lactic acidosis worsened until thiamine supplementation was started. Lactate normalized within 12 hours. Thiamine is an essential coenzyme in aerobic glycolysis, and deficiency leads to lactate accumulation through anaerobic glycolysis. Thiamine deficiency is uncommon in the pediatric population. However, it should be considered in patients at risk of nutritional deficiencies with lactic acidosis of unknown origin.
ISSN:2146-4618
2146-4626
DOI:10.1055/s-0040-1713382