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D-lactate is produced by bacteria residing in the colon when carbohydrates are not completely absorbed in the small intestine. When large amounts of D-lactate are present, individuals can experience metabolic acidosis, altered mental status (from drowsiness to coma), and a variety of other neurologic symptoms, particularly dysarthria and ataxia.
D-lactic acidosis is typically observed in patients with a malabsorptive disorder, such as short-bowel syndrome, or, following a jejunoileal bypass. In addition, healthy children presenting with gastroenteritis may also develop the critical presentation of D-lactic acidosis.
An adjunct to urine D-lactate (preferred), in the diagnosis of D-lactate acidosis
Increased levels are consistent with D-lactic acidosis. However, because D-lactate is readily excreted, urine determinations are preferred.
Urine is the preferred specimen to determine D-lactate.
The test performed was D-Lactate. This is a product of bacterial overgrowth in the gastrointestinal tract. It should not be confused with L-lactate which accumulates in some metabolic acidosis.
1. Brandt RB, Siegel SA, Waters MG, Bloch MH: Spectrophotometric assay for D-(-)-lactate in plasma. Anal Biochem1980;102(1):39-46
2. Petersen C: D-lactic acidosis. Nutr Clin Pract 2005;20(6):634-645