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Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Acute+Med+Surg 2014 ; 1 (2): 109-114 Nephropedia Template TP
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Alcoholic ketoacidosis that developed with a hypoglycemic attack after eating a high-fat meal #MMPMID29930832
Acute Med Surg 2014[Apr]; 1 (2): 109-114 PMID29930832show ga
CASE: Alcoholic ketoacidosis (AKA) usually occurs in patients with a history of prolonged alcohol abuse and recent binge drinking followed by abrupt cessation of alcohol consumption. OUTCOME: A 61-year-old man was brought to our emergency department. He had a history of eating barbecued beef with beer the previous night. He had unexplained hypoglycemia with high anion gap metabolic acidosis and fatty liver, and we strongly suspected AKA. After hydration with saline solution, dextrose, and thiamine, given i.v., his metabolic acidosis rapidly improved. A history of alcohol abuse and high serum beta-hydroxybutyrate concentration were subsequently confirmed, and the diagnosis of AKA was finally made. CONCLUSION: Our case suggests that a high-fat meal can induce AKA without abrupt cessation of alcohol consumption and that AKA should be considered when encountering patients with unexplained high anion gap metabolic acidosis with hypoglycemia and fatty liver, even if the past history of alcohol abuse is unknown.