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Clinical Chemistry 46: 1444-1445, 2000;
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(Clinical Chemistry. 2000;46:1444-1445.)
© 2000 American Association for Clinical Chemistry, Inc.

Letters

Rapid Enantiomeric Differentiation of Urinary Metabolites in a Patient with Bacterial Overgrowth Syndrome

Adrian C. Sewell1,a, Martin Heil2, Anika Blieke2, Armin Mosandl2 and Hans Böhles1

1 Department of Pediatrics, University Children’s Hospital, Theodor-Stern-Kai 7, 60596 Frankfurt, Frankfurt am Main, Germany

2 Department of Food Chemistry, University of Frankfurt, Frankfurt am Main, Germany
a Author for correspondence. Fax 49-69-6301-5229; e-mail asewell@zki.uni-frankfurt.de.


To the Editor:

Patients with short bowel syndrome (SBS) are prone to periods of acute life-threatening metabolic acidosis attributable to the accumulation of D-lactate caused by bacterial overgrowth (1)(2)(3) The malabsorption of carbohydrates in the gut leads to large amounts of D- and L-lactate produced by intestinal flora (3). Because only L-lactate is routinely analyzed in most laboratories, an unrecognized D-lactic acidosis can have severe neurological consequences if not diagnosed and treated promptly.

A 4-year-old boy with SBS after surgical correction for a small intestinal volvulus was admitted with a history of periodic metabolic acidosis. During a bout of fever, he developed a severe metabolic acidosis (pH 7.19; reference range, 7.35–7.45; . . . [Full Text of this Article]


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