We describe two Brazilian patients with HIV-associated neuromuscular weakness syndrome (HANWS), a unique clinical toxic syndrome that was recently reported in developed countries. Both patients were women, used stavudine and had hyperlactatemia, one of them with lactic acidosis. Electrophysiological studies were consistent with axonal neuropathy. After discontinuation of antiretroviral therapy ...

A 21-year-old woman presented with coma after 5 days of fever, gait ataxia, and somnolence. Brain MRI showed lesions in medial thalami, caudate heads, and periaqueductal region (figure). Hyperlactatemia was present; serum thiamine levels were normal. Thiamine IM 600 mg daily led to complete recovery within 3 days. Sequencing analysis of thiamine transporter 2 (THTR2) gene revealed a base deleti...

During septic shock, muscle produces lactate by way of an exaggerated NaKYadenosine triphosphatase (ATPase)Ystimulated aerobic glycolysis associated with epinephrine stimulation possibly through "2 adrenoreceptor involvement. It therefore seems logical that a proportion of hyperlactatemia in low cardiac output states would be also related to this mechanism. Thus, in low-flow and normal-to-highY...

Acid-base disorders are common in critically ill patients. Metabolic acid-base disorders are particularly common in patients who require acute renal replacement therapy. In these patients, metabolic acidosis is common and multifactorial in origin. Analysis of acid-base status using the Stewart-Figge methodology shows that these patients have greater acidemia despite the presence of hypoalbumine...