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[Alcoholic ketoacidosis (author's transl)]
La Nouvelle Presse Medicale
|November 12, 1979
Summary
Chronic alcoholism can cause ketoacidosis in nondiabetic patients, often unrecognized due to mild symptoms. This condition, alcoholic ketoacidosis, typically resolves without insulin, especially when combined with starvation and vomiting.
Area of Science:
- Endocrinology
- Gastroenterology
- Internal Medicine
Background:
- Chronic alcoholism is a significant health issue with diverse metabolic consequences.
- Ketoacidosis is typically associated with diabetes mellitus, but other causes exist.
- Alcoholic ketoacidosis (AKA) is an underdiagnosed metabolic derangement.
Observation:
- Seven episodes of AKA were observed in three nondiabetic patients.
- Patients presented with elevated anion gap, ketonuria, and ketonemia.
- Massive fatty liver was a consistent finding, alongside increased blood glucose and ammonia.
- Symptoms followed periods of increased alcohol intake combined with starvation and vomiting.
Findings:
- AKA can occur in nondiabetic individuals with a history of chronic alcohol abuse, starvation, and vomiting.
- The clinical presentation of AKA can be mild, leading to underdiagnosis.
- Serum lactate levels were below the anion excess, distinguishing it from other causes of high anion gap metabolic acidosis.
- Episodes resolved rapidly without insulin therapy when diagnosed correctly.
Implications:
- Recognizing AKA is crucial for appropriate management in nondiabetic patients with a history of alcoholism.
- Avoidance of unnecessary insulin administration can prevent hypoglycemia in AKA patients.
- Further research is needed to understand the precise mechanisms and prevalence of AKA.