D-Lactic Acidosis: More Prevalent Than We Think?

D-lactate acidosis, in which the D-isomer of lactate accumulates, may be more prevalent than once thought. This uncommon disorder has been reported in the setting of short bowel syndrome, and in particular, with high carbohydrate diets in children. Mental status changes and gait instability, the classic symptoms of D-lactate buildup, may not immediately lead the clinician to consider this uncommon disorder. The purpose of this article is to present information about D-lactate that will increase the readers’ level of vigilance for this disorder, which affects a broader group of patients than initially thought.