Auinger M, Weidinger S, Irsigler K
Ludwig-Boltzmann Institut für Stoffwechselerkrankungen und Ernährung, Krankenhaus der Stadt Wien-Lainz.
Wien Klin Wochenschr. 1992;104(14):414-7.
3 episodes of alcoholic ketoacidosis were observed in one female patient over a period of 19 months. The clinical picture consisted of vomiting, dehydration, hyperventilation and abdominal pain. Predominant laboratory findings were acidosis (pH less than 7) and hyperglycaemia, with blood glucose values of 354, 330 and 147 mg/dl. This disorder is an important cause of metabolic acidosis, but especially in the German literature there are only rare reports on this issue. The picture of ketoacidosis in mostly chronically malnourished alcoholics reflects not only the complex abnormalities of acid-base balance caused by excessive cumulation of ketoacids, but also the related severe depletion of electrolytes and extracellular volume. Adequate acute therapy (as for diabetic ketoacidosis) and thorough follow-up treatment of any concurrent conditions result in rapid reversal of the syndrome in most cases. Since there are few reports of repeated episodes in one patient, an overview of this disorder is presented concerning management and differential diagnosis of the basis of our case report.
在19个月的时间里,一名女性患者出现了3次酒精性酮症酸中毒。临床表现包括呕吐、脱水、呼吸急促和腹痛。主要实验室检查结果为酸中毒(pH值小于7)和高血糖,血糖值分别为354、330和147mg/dl。这种疾病是代谢性酸中毒的一个重要原因,但尤其是在德国文献中,关于这个问题的报道很少。大多数长期营养不良的酗酒者出现的酮症酸中毒情况,不仅反映了酮酸过度累积引起的复杂酸碱平衡异常,还反映了相关的严重电解质耗竭和细胞外液量减少。适当的急性治疗(如同糖尿病酮症酸中毒的治疗)以及对任何并发疾病的彻底后续治疗,在大多数情况下可使该综合征迅速逆转。由于关于同一患者反复发病的报道很少,本文根据我们的病例报告,对该疾病的管理和鉴别诊断进行了概述。