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Unit Code 8878:
D-Lactate, Plasma

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Useful For

As an adjunct to urine D-lactate (preferred), in the diagnosis of

D-lactate acidosis

Clinical Information

D-lactate is produced from carbohydrates not absorbed in the small

intestine by bacteria residing in the colon. When large amounts are

absorbed it can cause metabolic acidosis, altered mental status

(from drowsiness to coma) and a variety of other neurologic symptoms,

in particular dysarthria and ataxia. Although a temporal relationship has

been described between elevations of plasma and urine D-lactate and

the accompanying encephalopathy, the mechanism of neurologic

manifestations has not been elucidated.

 

D-lactic acidosis is typically observed in patients with short-bowel

syndrome and following jejunoileal bypass resulting in carbohydrate

malabsorption. In addition, healthy children presenting with gastroenteritis

may also develop the clinical presentation of D-lactic acidosis.

 

Measured concentrations are diagnostic, but It is important to realize that

lactic acid determinations in blood will not reveal abnormalities because

routine lactic acid assays measure only L-lactate. Accordingly, D-lactate

analysis must be specifically requested.

 

Reference Values

0.0-0.25 mmol/L

Interpretation

Increased levels are consistent with D-lactic acidosis. However, because

D-lactate is readily excreted, urine determinations are preferred.

Cautions

Urine is the preferred specimen to determine D-lactate.

Clinical Reference

1.   Dahlquist NR, Perrault J, Callaway CW, Jones JD: D-Lactic

      acidosis and encephalopathy after jejunoileostomy: response

      to overfeeding and to fasting in humans.  Mayo Clin Proc 1984;

      59:141-145

 

2.   Uribarri J, Oh MS, Carroll HJ: D-lactic acidosis. A review of

      clinical presentation, biochemical features, and

      pathophysiologic mechanisms. Medicine 1998;77:73-82

 

3.   Hingorani AD, Chan NN: D-lactate encephalopathy. Lancet

      2001;Nov 24;358(9295):1814

 

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