Friday July 25, 2008
Classification of Lactic acidosis


Q: What is Type B1, Type B2 and Type B3 Lactic acidosis?

A; Basically, there are 2 types of Lactic acidosis A and B

Type A lactic acidosis: occurs in the setting of poor tissue perfusion or oxygenation. It is due to either overproduction or underutilization

• Overproduction: Circulatory, pulmonary, or hemoglobin transfer disorders are commonly responsible.
• Underutilization: Liver disease, gluconeogenesis inhibition, thiamine deficiency, and uncoupled oxidative phosphorylation

Type B lactic acidosis: is when there is no evidence of poor tissue perfusion. Type B is divided into 3 subtypes

• Type B1 is assocciated with systemic disease such as renal and hepatic failure, diabetes, and malignancy.
• Type B2 is caused by drugs and toxins including biguanides, alcohols, iron, isoniazid, and salicylates. Recently HIV drugs have been described too.
• Type B3 is due to inborn errors of metabolism