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A 66-year-old man developed renal failure, lactic acidosis, refractory vasodilatory shock and metformin intoxication while receiving allopurinol, metformin and an ACE inhibitor [specific drug and details of administration not stated].
The man presented to an emergency department with stomach pain and sudden onset breathlessness. He had a history of type II diabetes, and was receiving metformin [route and duration of treatment not stated]. He had also been receiving allopurinol [dosage and route not stated] for 1 month, for gout. His wife reported that he had been unusually tired in recent months. In the previous 24 hours he had...