Alcoholic ketoacidosis
Caspar, C.B.; Risti, B.; Iten, P.X.; Jost, R.; Russi, E.W.; Speich, R.
Schweizerische Medizinische Wochenschrift 123(41): 1929-1934
1993
ISSN/ISBN: 0036-7672 PMID: 8259474 Document Number: 420337
Alcoholic ketoacidosis (AKA) is an important and probably underdiagnosed differential diagnosis for metabolic acidosis with an increased anion gap. It occurs in patients with prolonged ethanol intake. After a brief period of starvation induced by alcoholic gastritis patients typically present with vomiting, abdominal pain and Kussmaul breathing. Routine testing for urine or serum ketones with ketostix may be negative, since they do not detect beta-hydroxybutyrate and this is characteristically elevated in AKA. We present three cases of AKA and discuss diagnosis, pathophysiology and management of this disorder.