{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T22:22:55Z","timestamp":1788906175447,"version":"build-2803163510"},"reference-count":10,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T00:00:00Z","timestamp":1722384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec><jats:title>Key Clinical Message<\/jats:title><jats:p>Metformin\u2010associated lactic acidosis is a rare but serious complication in patients with type 2 diabetes, especially those with multiple health conditions. Prompt recognition and treatment, including potential renal replacement therapy, are crucial for managing severe acidosis and improving patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Metformin (MTF) is commonly prescribed as a first\u2010line treatment for diabetes, effectively preventing microvascular and macrovascular complications. However, metformin\u2010associated lactic acidosis is a rare yet severe complication, associated with a mortality rate of up to 50%. We encountered a case involving a 73\u2010year\u2010old woman with type 2 diabetes, mental illness, and hypothyroidism, who developed life\u2010threatening lactic acidosis while on metformin therapy. Upon presenting to the emergency department with complaints of weakness, nausea, and decreased urination for 5\u2009days, she also reported abdominal pain and shortness of breath. Hypotension was noted with a blood pressure of 80\/50\u2009mmHg. Initial laboratory results revealed severe acidosis, prompting discontinuation of MTF. Despite resuscitation efforts and vasopressor therapy, severe acidemia persisted, leading to the initiation of renal replacement therapy. Following treatment with continuous renal replacement therapy, her acidemia resolved, and she was discharged from the hospital on the sixth day without complications, with normal kidney function.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccr3.9255","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T04:24:05Z","timestamp":1722486245000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A case report of metformin\u2010associated lactic acidosis"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2730-7469","authenticated-orcid":false,"given":"Mohammed","family":"Taha","sequence":"first","affiliation":[{"name":"Department of Internal Medicine University of Gezira  Gezira Sudan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2804-1408","authenticated-orcid":false,"given":"Ayman","family":"Azhary","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medical Laboratory Sciences Omdurman Islamic University  Khartoum Sudan"},{"name":"Molecular Biology Unit Sirius Training and Research Centre  Khartoum Sudan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3717-1815","authenticated-orcid":false,"given":"Nooh Mohamed","family":"Hajhamed","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medical Laboratory Sciences Omdurman Islamic University  Khartoum Sudan"},{"name":"Molecular Biology Unit Sirius Training and Research Centre  Khartoum Sudan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0963-4622","authenticated-orcid":false,"given":"Waleed Azhary","family":"Sir\u00a0Alkhatim","sequence":"additional","affiliation":[{"name":"Sudan Medical Specialization Board  Khartoum Sudan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah M.","family":"Bakheit","sequence":"additional","affiliation":[{"name":"Molecular Biology Unit Sirius Training and Research Centre  Khartoum Sudan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8572-3942","authenticated-orcid":false,"given":"Abdallah Elssir","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Molecular Biology Unit Sirius Training and Research Centre  Khartoum Sudan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,31]]},"reference":[{"issue":"7","key":"e_1_2_13_2_1","first-page":"658","article-title":"Metformin: current knowledge","volume":"19","author":"Nasri H","year":"2014","journal-title":"J Res Med Sci"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-017-4336-x"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40800-018-0076-1"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.15298"},{"key":"e_1_2_13_6_1","volume-title":"Metformin\u2010Associated Lactic Acidosis (MALA)","author":"Dyatlova N","year":"2024"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002967.pub4"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-013-0038-6"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc9376"},{"key":"e_1_2_13_10_1","first-page":"45","article-title":"Metformin\u2010associated lactic acidosis requiring hospitalization. A national 10 year survey and a systematic literature review","volume":"17","author":"Renda F","year":"2013","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-8-159"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.9255","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,14]],"date-time":"2024-09-14T04:29:30Z","timestamp":1726288170000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.9255"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,31]]},"references-count":10,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1002\/ccr3.9255"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.9255","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,31]]},"assertion":[{"value":"2024-06-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e9255"}}