Lactic acidosis and hyperamylasaemia associated with phenformin therapy.

Introduction Lactic acidosis, first described by Clausen (1925), is most frequently seen accompanying hypotension and impaired tissue perfusion, but has been reported in association with many other conditions such as phenformin therapy, non-ketotic diabetic acidosis, ethanol ingestion and glycogen storage disease (Oliva, 1970; Lancet, 1973). Recently, an association was suggested between non-ketotic diabetic acidosis, pancreatitis and treatment with phenformin (Levitan, 1973; Coodley, Derasse and Carver, 1973). We report such a patient with severe acidosis, elevated blood lactate and serum amylase, in whom there was no clinical or pathological evidence of pancreatitis.