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[Alcoholic ketoacidosis – a review]
1- , Sweden - , Sweden.
Lakartidningen
|October 11, 2017
Summary
Alcoholic ketoacidosis is a common cause of metabolic acidosis in chronic alcoholics, often missed due to misleading urine ketone tests. Prompt treatment with fluids, electrolytes, glucose, and thiamine improves prognosis.
Area of Science:
- Internal Medicine
- Toxicology
- Emergency Medicine
Background:
- Metabolic acidosis in chronic alcoholics presents diagnostic challenges.
- Alcoholic ketoacidosis is an under-recognized cause, distinct from methanol or ethylene glycol intoxication.
- It arises from binge drinking followed by cessation, leading to dehydration, starvation, and ketoacidosis.
Purpose of the Study:
- To review alcoholic ketoacidosis as a differential diagnosis for metabolic acidosis in alcoholic patients.
- To highlight diagnostic challenges, including misleading urine ketone tests.
- To discuss current treatment and prognosis.
Main Methods:
- Literature review of alcoholic ketoacidosis.
- Analysis of diagnostic criteria and laboratory findings.
- Summary of treatment protocols and outcomes.
Main Results:
- Alcoholic ketoacidosis is characterized by beta-hydroxybutyrate-dominant ketoacidosis.
- Standard urine ketone tests may be falsely negative or weakly positive.
- Treatment involves fluid, electrolyte, glucose, and thiamine replacement.
Conclusions:
- Alcoholic ketoacidosis requires recognition as a treatable cause of metabolic acidosis in alcohol-dependent individuals.
- Accurate diagnosis is crucial, despite potential misleading lab results.
- Early intervention improves short-term outcomes, but mortality risk in alcohol dependence remains a concern.
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