A Unique Case of Metformin-Associated Lactic Acidosis

Table 1

Initial laboratory results [normal values in parentheses].

Hb [g/L]	130
WBC [x10^9/L]	17.3 [4.0 – 11.0]
Platelets [x10^9/L]	286 [150 – 400]
pH [Venous]	6.85 [7.33 – 7.46]
pCO2 [Venous] [mmHg]	19.3 [40.0 – 50.0]
[Venous] [mmol/L]	3.4 [22.0 – 27.0]
Na^+ [mmol/L]	145 [135 – 145]
K^+ [mmol/L]	8.3 [3.5 – 5.1]
Cl^- [mmol/L]	101 [100 – 110]
Anion Gap [mmol/L]	40.6 [5 – 12]
Albumin [g/L]	28 [34 – 46]
Glucose [mmol/L]	1.4 [4.0 – 11.0]
Creatinine [µmol/L]	967 [58 – 110]
Urea [mmol/L]	31.2 [2.5 – 7.0]
[mmol/L]	3.68 [0.80 – 1.45]
Ca^2+ [mmol/L]	2.43 [2.20 – 2.52]
Mg^2+ [mmol/L]	0.84 [0.65 – 0.90]
Bilirubin [µmol/L]	6 [3 – 17]
ALT [Alanine Aminotransferase] [U/L]	22
AST [Aspartate Aminotransferase] [U/L]	32 [15 – 45]
ALP [Alkaline Phosphatase] [U/L]	44 [40 – 115]
aPTT [Activated Partial Thromboplastin Time] [s]	45
PT [Prothrombin Time] [s]	21.3 [10.1 – 14.6]
INR [International Normalized Ratio]	1.9 [0.9 – 1.2]
Lipase [U/L]	351 [45 – 300]
Lactate [mmol/L]	14.9 [0.5 – 2.2]
CK [Creatinine Kinase] [U/L]	65 [30 – 200]
Troponin I [ng/L]	32 [<30]