Clinical Communication to the Editor| Volume 131, ISSUE 8, e335-e336, August 2018

Persistent Profound Lactic Acidosis: an Unusual Case

      A 45-year-old man presented to the hospital with exertional dyspnea and myalgias. He was promptly referred to Internal Medicine for laboratory abnormalities—most strikingly, a lactic acid of 22 mmol/L. He reported several weeks of dyspnea, myalgias, acute on chronic abdominal pain, weight loss, and general malaise. Aside from blindness from congenital cataracts, he had no past medical history, nor known family history. Despite the metabolic derangements, he appeared well and hemodynamically stable. He had no clinical evidence of ischemia nor sepsis. His examination was significant only for widespread pain with muscle palpation and mild proximal hip weakness.
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