Lactic acidosis with necrotizing encephalopathy in two sibs.

Abstract

The plasma lactate concentration is raised physiologically, during muscular exertion, and sometimes in diseases associated with demonstrable hypoxaemia, such as peripheral circulatory failure, severe shock, acute bronchial asthma, and obstructive emphysema. The plasma lactate level is also significantly raised in respiratory alkalosis arising from primary hyperventilation, and often in metabolic alkalosis. When there is alkalosis, there is usually no hypoxaemia, and the plasma concentration of pyruvate, the immediate precursor of lactate, is also proportionally raised. Gevers and Dowdle (1963) have shown that alkaline conditions stimulate the glycolytic rate in vitro of rat liver and kidney slices and that the effect is exerted at a stage or stages proximal to the dehydrogenation of triosephosphate.