Acute lactic acidosis as a complication of thiamine-free parenteral nutrition in two neutropenic children

Following a national out-of-stock of pharmaceutical speciality made with multivitamins formula for intravenous infusion, two hospitalized children with immuno-hematological disorder receiving vitamins-unsupplemented total parenteral nutrition (TPN), had acute lactic acidosis associated with neurological and respiratory symptoms. Clinical and biological signs had quickly resolved after the intravenous administration of thiamine. The thiamine deficiency is an uncommon complication of TPN. This complication remains unrecognized especially in patients with serious diseases in which acidosis could be multifactorial.