Alcoholic ketoacidosis that developed with a hypoglycemic attack after eating a high‐fat meal. Issue 2 (16th December 2013)

• Record Type: Journal Article
• Authors: Suzuki, Kei; Tamai, Yasuyuki; Urade, Shinji; Ino, Kazuko; Sugawara, Yumiko; Katayama, Naoyuki; Hoshino, Tamotsu
• Is Part Of: Acute medicine & surgery. Volume 1:Issue 2(2014)
• Page Start: 109
• Page End: 114
• Publication Date: 2013-12-16
• Subjects: Surgery -- Periodicals; Medical emergencies -- Periodicals; 617.005
• DOI: 10.1002/ams2.13
• Languages: English
• ISSNs: 2052-8817

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ams213-sec-0001" sec-type="section"> <title>Case</title> <p>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.</p> </sec> <sec id="ams213-sec-0002" sec-type="section"> <title>Outcome</title> <p>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 β‐hydroxybutyrate concentration were subsequently confirmed, and the diagnosis of AKA was finally made.</p> </sec> <sec id="ams213-sec-0003" sec-type="section"> <title>Conclusion</title> <p>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.</p> </sec> </abstract>