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)
Interpretation:
• A ratio > 25 indicated primary or secondary respiratory chain dysfunction.
• A ratio < 25 indicates pyruvate dehydrogenase deficiency.
Limitations:
• 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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