Fatal Phenformin-Associated Lactic Acidosis

Abstract

Letters15 July 1997Fatal Phenformin-Associated Lactic AcidosisJonathan Rosand, MD, Jonathan W. Friedberg, MD, and Jane M. Yang, MDJonathan Rosand, MDMassachusetts General Hospital; Boston. MA 02114, Jonathan W. Friedberg, MDMassachusetts General Hospital; Boston. MA 02114, and Jane M. Yang, MDMassachusetts General Hospital; Boston. MA 02114Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-2-199707150-00034 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The popularity of metformin has renewed interest in biguanide hypoglycemic agents. The association between phenformin and fatal lactic acidosis, particularly in patients with renal failure, led to the withdrawal of phenformin from the U.S. market in 1977 [1]. We describe a patient who recently died of phenformin-associated lactic acidosis.A 64-year-old Haitian woman with diabetes, hypertension, and consequent renal insufficiency presented with profound lactic acidosis (pH, 7.15; bicarbonate level <5.0 mmol/L; lactic acid level, 54.5 mmol/L). She had been hospitalized on four previous occasions for unexplained severe lactic acidosis. After recovery from such an episode, muscle biopsy ...References1. Misbin RI. Phenformin-associated lactic acidosis: pathogenesis and treatment. Ann Intern Med. 1977; 87:591-5. Google Scholar2. Reznik-Schuller HM, Reuber MD. Ultrastructure of liver tumors induced in F344 rats by methapyrilene. J Environ Pathol Toxicol Oncol. 1986; 7:181-96. Google Scholar3. Bailey CJ, Turner RC. Metformin. N Engl J Med. 1996; 334:574-9. Google Scholar Author, Article, and Disclosure InformationAffiliations: Massachusetts General Hospital; Boston. MA 02114 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFrom old to new — Repurposing drugs to target mitochondrial energy metabolism in cancerThe Surprising Effect of Phenformin on Cutaneous Darkening and Characterization of Its Underlying Mechanism by a Forward Chemical Genetics ApproachReview of Biguanide (Metformin) ToxicitySynergistic Anti-Cancer Effect of Phenformin and OxamateMetformin: an old but still the best treatment for type 2 diabetesReview: Metformin: Potential benefits and use in chronic kidney diseaseInsulin, glucagon, and hypoglycemic drugs 15 July 1997Volume 127, Issue 2Page: 170KeywordsAutopsyBicarbonatesDehydrogenasesElectron microscopyHepatocytesLactic acidosisMitochondriaPyruvateRenal failureSodium Issue Published: 15 July 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...