[Ketoacidosis after cessation of chronic alcohol consumption]

A 52-year-old man was admitted with diarrhea, near dehydration and dyspnoea. After many years of alcohol consumption, he had stopped drinking alcohol over a very short space of time and had eaten very little or nothing. He had tachypnoea, hypotension and an enlarged liver. Laboratory analysis revealed metabolic acidosis with an elevated anion gap, ketone bodies in the urine, increased free fatty acid levels and beta-hydroxybutyrate in the serum, fitting the picture of alcoholic ketoacidosis. The syndrome is explained by metabolic changes induced by chronic alcohol consumption and ketogenesis as the result of fasting and dehydration. Treatment consisted of correction of the fluid deficit and administration of glucose, after which the patient made a rapid recovery.