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Sickle erythrocytes and platelets augment lung leukotriene synthesis with downregulation of anti-inflammatory proteins: relevance in the pathology of the acute chest syndrome

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An accumulation of lactate to dangerous levels ( lactic acidosis ) can occur when metformin is taken by patients with other conditions resulting metabolic acidosis (liver disease, heart failure, sepsis, alcohol abuse), or kidney disease (as indicated by elevated creatinine levels) because metformin is eliminated by renal excretion) (He & Wondisford, 2015