Pediatric Metabolic Acidosis Differential Diagnoses

  • Author: Lennox H Huang, MD, FAAP; Chief Editor: Timothy E Corden, MD   more...
 
Updated: Feb 17, 2012
 
 

Diagnostic Considerations

Other conditions

Other conditions to consider in metabolic acidosis, along with those in the next section, include the following:

  • Renal tubular acidosis
  • Lactic acidosis
  • Cyanide toxicity
  • Ethylene glycol toxicity
  • Methanol toxicity
  • Dilated cardiomyopathy
  • Chronic kidney disease
  • Coarctation of the aorta
  • Dehydration
  • Ornithine transcarbamylase deficiency
  • Phenylketonuria
  • Pneumococcal bacteremia
  • Sepsis
  • Toxic shock syndrome
  • Diarrhea
  • Hyperammonemia
  • Hypoplastic left heart syndrome
  • Interrupted aortic arch
  • Intestinal volvulus
  • Neonatal sepsis
  • Neuroleptic malignant syndrome
  • Isoniazid toxicity
  • Salicylate toxicity
  • Meningococcal infections
  • Diabetic ketoacidosis

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Lennox H Huang, MD, FAAP  Associate Professor and Chair, Department of Pediatrics, McMaster University School of Medicine; Chief of Pediatrics, McMaster Children's Hospital

Lennox H Huang, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Physician Executives, Canadian Medical Association, Ontario Medical Association, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Margaret A Priestley, MD  Assistant Professor of Clinical Anesthesiology and Critical Care, University of Pennsylvania School of Medicine; Clinical Director, Pediatric Intensive Care Unit, The Children's Hospital of Philadelphia

Margaret A Priestley, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Chief Editor

Timothy E Corden, MD  Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin

Timothy E Corden, MD is a member of the following medical societies: American Academy of Pediatrics, Phi Beta Kappa, Society of Critical Care Medicine, and Wisconsin Medical Society

Disclosure: Nothing to disclose.

Additional Contributors

G Patricia Cantwell, MD, FCCM Professor of Clinical Pediatrics, Chief, Division of Pediatric Critical Care Medicine, University of Miami, Leonard M Miller School of Medicine; Medical Director, Palliative Care Team, Director, Pediatric Critical Care Transport, Holtz Children's Hospital, Jackson Memorial Medical Center; Medical Manager, FEMA, Urban Search and Rescue, South Florida, Task Force 2; Pediatric Medical Director, Tilli Kids – Pediatric Initiative, Division of Hospice Care Southeast Florida, Inc

G Patricia Cantwell, MD, FCCM is a member of the following medical societies: American Academy of Hospice and Palliative Medicine, American Academy of Pediatrics, American Heart Association, American Trauma Society, National Association of EMS Physicians, Society of Critical Care Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Barry J Evans, MD Assistant Professor of Pediatrics, Temple University Medical School; Director of Pediatric Critical Care and Pulmonology, Associate Chair for Pediatric Education, Temple University Children's Medical Center

Barry J Evans, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

References

  1. Kraut JA, Madias NE. Metabolic acidosis: pathophysiology, diagnosis and management. Nat Rev Nephrol. May 2010;6(5):274-85. [Medline].

  2. Glaser N, Barnett P, McCaslin I, Nelson D, Trainor J, Louie J, et al. Risk factors for cerebral edema in children with diabetic ketoacidosis. The Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics. N Engl J Med. Jan 25 2001;344(4):264-9. [Medline].

  3. Hodson E. Metabolic acidosis and growth in children. Nephrology. Dec 2005;10(S5):S221-2. [Full Text].

  4. Han JJ, Yim HE, Lee JH, Kim YK, Jang GY, Choi BM, et al. Albumin versus normal saline for dehydrated term infants with metabolic acidosis due to acute diarrhea. J Perinatol. Jun 2009;29(6):444-7. [Medline].

  5. Forsythe SM, Schmidt GA. Sodium bicarbonate for the treatment of lactic acidosis. Chest. Jan 2000;117(1):260-7. [Medline].

  6. Manthous CA. Lactic acidosis in status asthmaticus : three cases and review of the literature. Chest. May 2001;119(5):1599-602. [Medline].

  7. Agarwal B, Kovari F, Saha R, Shaw S, Davenport A. Do Bicarbonate-Based Solutions for Continuous Renal Replacement Therapy Offer Better Control of Metabolic Acidosis than Lactate-Containing Fluids. Nephron Clin Pract. Feb 23 2011;118(4):c392-c398. [Medline].

 
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Approach for evaluating metabolic acidosis.
 
 
 
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