The molar ratio of lactate to pyruvate can help identify the cause of congenital lactic acidosis.


molar ratio of lactate to pyruvate =

= (lactate in mmol/L) / (pyruvate in mmol/L)



• A ratio > 25 indicated primary or secondary respiratory chain dysfunction.

• A ratio < 25 indicates pyruvate dehydrogenase deficiency.



• Accurate measurement of lactate and pyruvate concentrations require immediate deproteinization and rapid testing (see Chapter 41). Improper specimen collection can elevate the ratio 2-3 fold.


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