Examining clinical similarities between myalgic encephalomyelitis/chronic fatigue syndrome and D-lactic acidosis: a systematic review

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lactic acidosis 137 MedicineExamining clinical similarities between myalgic encephalomyelitis/chronic fatigue syndrome and d- lactic acidosis : a systematic reviewAmy WallisMichelle BallSandra McKechnieHenry ButtDonald P. LewisDorothy BruckPublication
lactic acidosis 817 producing bacteria in ME/CFS raise questions about shared mechanisms with the acute condition of d- lactic acidosis (d-la).Methodsd-la case reports published between 1965 and March 2016 were reviewed for episodes describing
lactic acidosis 7309 flowchart of systematic search and article selection. Asterisk eligibility criteria included episodes of d- lactic acidosis where both neurological symptoms and d-lactate levels were reportedQualitative synthesisSixty-eight
lactic acidosis 13101 ambiguous/other.Table 2Mapping overlap between myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and d- lactic acidosis (d-la) symptomsME/CFS International Consensus Criteria [[1]]d-la symptoms mapped to ME/CFS criteriaMatchingAmbiguous/otherA.
lactic acidosis 17319 identified as consistent with ME/CFS presentation (see Table 2 for detailed symptom delineation), d-lad- lactic acidosis , matching: mapped overlap between ME/CFS and d-la symptoms, ME/CFS myalgic encephalomyelitis/chronic
lactic acidosis 22438 female) and total episodes.Table 3Frequency of episodes that reported matching and/or ambiguous/otherd- lactic acidosis (d-la) symptoms as a function of age and sexME/CFS ICCd-La symptom overlap with ME/CFSEpisode frequenciesPaediatric
lactic acidosis 24815 neurocognitive impairments, pain, sleep disturbances, neurosensory and perceptual, motor disturbances, d-lad- lactic acidosis , ICC International Consensus Criteria, Matching mapped overlap between ME/CFS and d-la symptoms, ME/CFS
lactic acidosis 28421 overlap between matching symptoms and ambiguous/other neurological symptoms.Fig. 2Percentages of d- lactic acidosis (d-la) episodes that reported ME/CFS matching and ambiguous/other neurological impairments. Total percentages
lactic acidosis 33139 and distinct symptoms in these acute and chronic clinical conditions.Fig. 3Proposed continuum of d- lactic acidosis and ME/CFS symptoms. A continuum showing, from left to right; distinct myalgic encephalomyelitis/chronic
lactic acidosis 33317 distinct myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) symptoms, shared and distinctd- lactic acidosis (d-la) symptoms. Continuum also shows chronic compared to acute presentationsThis qualitative synthesis
lactic acidosis 41505 identify shared pathophysiology between d-la and ME/CFS.Part B. Narrative reviewProposed mechanisms in d- lactic acidosis Understanding d-la involves firstly establishing the reason for increased d-lactate levels before examining
lactic acidosis 41935 that exceeds the metabolic and/or excretion capacity of the patient.Fig. 4Overview of mechanisms in d- lactic acidosis . Legend. Summary of contextual factors, triggers and proposed mechanisms leading to d-lactic acidosis
lactic acidosis 42037 d-lactic acidosis. Legend. Summary of contextual factors, triggers and proposed mechanisms leading to d- lactic acidosis (d-la). A presentation of d-la requires an increase in d-lactate absorption. The proposed mechanisms
lactic acidosis 47621 accumulation and the clinical presentation of an episode of d-la.Proposed neurological mechanisms in d- lactic acidosis Metabolic acidosis and increased d-lactate levels are synonymous with the presentation of d-la. However,
lactic acidosis 48761 Fig. 5).Fig. 5Proposed mechanisms of gut–brain interaction leading to neurological symptoms observed in d- lactic acidosis . Supporting and opposing evidence for proposed central nervous system (CNS) mechanisms are categorised
lactic acidosis 49621 [114]]) and result in systemic inflammation. For example, in ruminants, preliminary findings showed that lactic acidosis (lowered pH and increased faecal lactate) was significantly associated with increased tumor necrosis
lactic acidosis 76708 treatment outcomes.Additional filesAdditional file 1: Table S1. Demographic and clinical data summary of d- lactic acidosis episodes (n = 59) included in the qualitative synthesis. All episodes simultaneously reported at least
lactic acidosis 77495 marked with an asterisk.Additional file 2: Table S2. Episodes that reported matching or ambiguous/otherd- lactic acidosis (d-la) symptoms as a function of age and sex

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