In our investigation of an episode of clustered acute epiglottitis occurring in Vendée, western France, between October and December 2022, we described the reported cases and confirmed its unusual character at several geographic levels. 

Investigation of a cluster of acute epiglottitis in Vendée, western France, October – December 2022

Laringitis agudas en el adulto

Laringiti acute dell’adulto

Épiglottites aiguës sévères de l’adulte

La metformine, seul representant disponible en France de la classe des biguanides, est un medicament antidiabetique largement prescrit. L’effet therapeutique benefique du controle glycemique obtenu par inhibition de la neoglucogenese est objective par une reduction de la morbimortalite chez les patients diabetiques de type 2. Neanmoins, la metformine affecte aussi le metabolisme du lactate en augmentant sa production par la cellule. Ainsi, l’effet secondaire le plus redoute est l’acidose lactique associee a la metformine (metformin-associated lactic acidosis [MALA]). Celle-ci est liee a une augmentation brutale de la concentration en metformine dans le sang et dans les tissus, que ce soit apres ingestion d’une grande quantite de medicament ou plus souvent dans les suites d’une insuffisance renale aigue chez un patient traite au long cours. Dans ce contexte d’acidose metabolique majeure avec hyperlactatemie, la severite des defaillances d’organes conditionne le pronostic. La prise en charge therapeutique est symptomatique avec recours precoce a une epuration extrarenale dans les formes severes ou ne repondant pas au traitement initial. La prevention de la MALA repose avant tout sur le respect des contreindications de la metformine chez les patients diabetiques.

Intoxication à la metformine

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Épiglottites aiguës sévères de l’adulte

Intoxication à la metformine