What is the most likely cause of anion gap acidosis in this patient?
An acidosis can be caused by several things. Medication-induced renal tubular acidosis and chronic diarrhea can cause an acidosis, but not a gap acidosis, as seen here. Sepsis can cause lactic with an anion gap, but this patient did not appear to have sepsis clinically. This patient’s gap acidosis was caused by medication-induced lactic academia. Lactic academia and mitochondrial toxicity in HIV infection The mitochondria are the body’s battery packs, producing and storing adenosine triphosphate (ATP) through a (non-lactate-producing) process of cellular respiration and breaking it down when energy is required. The number of mitochondria in cells of any particular tissue varies, depending on tissue energy requirements. Cells of relatively quiescent tissue may contain only a few mitochondria; the cells of tissues with higher energy requirements – such as muscle, liver, and nerves – may contain thousands of mitochondria. Mitochondria have their own DNA strands (mtDNA) that are replicated
