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Alcohol-Related Metabolic Emergencies
Lorelle Knight-Dunn1, Julie Gorchynski2
1Creighton University, Omaha, NE 68178, USA.
Endocrinology and Metabolism Clinics of North America
|February 8, 2026
Summary
Patients with alcohol use disorders often present to the emergency department. Metabolic derangements like alcoholic ketoacidosis can mimic intoxication, leading to misdiagnosis by clinicians.
Area of Science:
- Emergency Medicine
- Toxicology
- Metabolic Disorders
Background:
- Alcohol use disorders are frequently encountered in emergency departments.
- While many patients are discharged after sobering, some have underlying conditions that mimic intoxication.
- Early identification of these conditions is crucial for appropriate patient management.
Purpose of the Study:
- To highlight common metabolic derangements in patients with alcohol use disorders.
- To emphasize the potential for misdiagnosis of these conditions as simple intoxication.
- To improve emergency clinician awareness and diagnostic accuracy.
Main Methods:
- Review of common metabolic complications associated with alcohol use.
- Analysis of clinical presentations that overlap with alcohol intoxication.
- Discussion of diagnostic challenges in the emergency department setting.
Main Results:
- Alcoholic ketoacidosis, Wernicke-Korsakoff syndrome, and potomania are common metabolic derangements.
- These conditions can present with symptoms indistinguishable from alcohol intoxication.
- Misdiagnosis can lead to delayed or inappropriate treatment.
Conclusions:
- Emergency clinicians must consider metabolic derangements in patients presenting with alcohol-related issues.
- Differential diagnosis should include alcoholic ketoacidosis, Wernicke-Korsakoff syndrome, and potomania.
- Increased awareness and targeted diagnostic approaches are needed to prevent misdiagnosis.
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