고의적 metformin 과복용 후 발생한 중증 유산 산증 치험 1예

Abstract

Metformin is an oral hypoglycemic agent belonging to the biguanide class that has been used to treat type II diabetes mellitus worldwide. Lactic acidosis is a rare, but serious, adverse effect in metformin-treated patients with renal and hepatic disease, cardiac or respiratory insufficiency, severe infection, and any hypoxic condition. Large overdoses of metformin can also lead to lactic acidosis. Attempted suicide with metformin is rare. Treatment with bicarbonate is generally accepted, although there is no clear evidence that it improves the outcome of lactic acidosis. Bicarbonate hemodialysis and continuous veno-venous hemodiafiltration (CVVHDF) are probably both beneficial in correcting the acidosis, and by actively removing metformin and lactate from the circulation. We report the case of a patient with severe lactic acidosis induced by metformin intoxication who recovered fully after treatment with a combination of bicarbonate hemodialysis and CVVHDF