Starvation is a rare cause of metabolic ketoacidosis
Vestergaard, T.; Aaen, J.F.øk.ær.; Bruun, J.M.
Ugeskrift for Laeger 176(45)
2014
ISSN/ISBN: 1603-6824 PMID: 25394839 Document Number: 671537
A 79-year-old woman with no medical history was admitted under the diagnosis of stroke. Two months prior she had a fractured tibia, complicated by osteomyelitis. Physical examination showed dehydration and malnourishment. Chest X-ray revealed pneumonia and laboratory data revealed signs of infection, dehydration and normoglycaemic metabolic acidosis with elevated P-3-hydroxybutyrate. The case presents a starvation- (weight loss ~ 13 kg) and infection-induced non-diabetic metabolic ketoacidosis treated with intravenous supplementation of isotonic saline, potassium, bicarbonate and insulin.