LACTIC ACIDOSIS IN EPINEPHRINE POISONING

. Lactic acidosis as a result of epinephrine poisoning is discussed. A case report illustrates the clinical condition after a very large dosage of epinephrine (20 mg i.v.). The pathogenesis of lactic acidosis in this situation is discussed and suggested to be of type II A and II B according to Huckabee. We advocate the treatment with insulin, glucose and bicarbonate. Lactic acidosis was first mentioned in 1925 in dehydrated children (2), but this work did not provoke any investigation of the etiology of lactic acidosis until Huckabee (5) in 1961 analysed the causes of elevated lactate concentrations in the blood. Recently Oliva (8) has published a review on the subject. We have observed an unusual cause of lactic acidosis—epinephrine poisoning—and we here discuss the possible mechanism of lactic acidosis on the basis of the present case.