AUTHOR=Kortli Said , Amathieu Roland , Ghalayini Mohamed 

TITLE=Dancing with death at pH 6.8 and lactate of 29 mmol/L: extreme survival in severe metformin-associated lactic acidosis - a case report

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1604360

DOI=10.3389/fmed.2025.1604360

ISSN=2296-858X

ABSTRACT=Lactic acidosis is a serious metabolic disorder characterized by an accumulation of lactate in the body, which can lead to a severe acid-base imbalance. Metformin-associated lactic acidosis is a rare but life-threatening complication of metformin therapy, particularly in the setting of acute kidney injury or other conditions that impair lactate clearance. In this case report, we present the remarkable survival of a patient who experienced severe metformin-associated lactic acidosis with a blood pH of 6.8 and a lactate level of 29 mmol/L, which are typically considered incompatible with life.