Alcoholic ketoacidosis (AKA) is a metabolic complication that occurs in individuals with chronic alcohol use or after binge drinking, especially in the context of poor nutritional intake and prolonged fasting. It is characterized by the accumulation of ketone bodies in the blood, leading to metabolic acidosis.
Key Features:
Pathophysiology:
Alcohol consumption impairs gluconeogenesis and reduces insulin secretion.
This leads to increased lipolysis and fatty acid oxidation, resulting in ketone production (e.g., β-hydroxybutyrate and acetoacetate).
The condition is often exacerbated by vomiting, dehydration, and malnutrition.
Symptoms:
Nausea, vomiting, and abdominal pain.
Tachypnea (rapid breathing) and a fruity odor on the breath.
Symptoms of dehydration, such as dizziness and dry mucous membranes.
Laboratory Findings:
High anion gap metabolic acidosis: Elevated anion gap due to ketone accumulation.
Ketonemia and Ketonuria: Presence of ketones in blood and urine.
Normal or Low Blood Glucose: Unlike diabetic ketoacidosis, glucose levels are not significantly elevated.
Electrolyte imbalances, such as hypokalemia, hypomagnesemia, and hypophosphatemia.
Diagnosis:
Based on clinical history (e.g., alcohol use) and laboratory findings.
Exclusion of other causes of high anion gap metabolic acidosis, such as diabetic ketoacidosis or toxic alcohol ingestion.
Treatment:
Intravenous Fluids: To correct dehydration and electrolyte imbalances.
Dextrose Infusion: To suppress ketone production and restore glucose metabolism.
Thiamine Supplementation: To prevent Wernicke’s encephalopathy.
Management of alcohol withdrawal symptoms if present
#Ketoacidosis
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