Nnodum Benedicta Nneoma, Oduah Eziafa, Albert David, Pettus Mark
Berkshire Medical Center, Pittsfield, MA 01201, USA.
Case Rep Nephrol. 2019 Jul 8;2019:1214208. doi: 10.1155/2019/1214208. eCollection 2019.
The ketogenic diet (KD) is a high-fat, adequate-protein, and low-carbohydrate diet that leads to nutritional ketosis and weight loss. It is known to induce ketosis but is not an established cause of clinically significant ketoacidosis. Lactation ketoacidosis is well established in bovine literature but remains a rare phenomenon in humans. Here we present a life-threatening case of severe ketoacidosis in a nondiabetic lactating mother on a strict ketogenic diet. We review the available case reports of lactation ketoacidosis in humans and the mechanisms thereof. Although ketogenic diet has been shown to be safe in nonpregnant individuals, the safety of this diet in lactating mothers is not known. Health professionals and mothers should be made aware of the potential risk associated with a strict ketogenic diet when combined with lactation. Prompt diagnosis and immediate treatment cannot be overemphasized. To our knowledge, this is the first reported case of life-threatening lactation ketoacidosis associated with ketogenic diet while consuming an adequate number of calories per day.
生酮饮食（KD）是一种高脂肪、适量蛋白质和低碳水化合物的饮食，可导致营养性酮症和体重减轻。已知它会诱发酮症，但并非临床上显著酮症酸中毒的确切病因。泌乳性酮症酸中毒在牛类文献中已有充分记载，但在人类中仍然是一种罕见现象。在此，我们报告一例严格遵循生酮饮食的非糖尿病哺乳期母亲发生危及生命的严重酮症酸中毒病例。我们回顾了人类泌乳性酮症酸中毒的现有病例报告及其机制。虽然生酮饮食已被证明在非孕妇个体中是安全的，但这种饮食在哺乳期母亲中的安全性尚不清楚。应让健康专业人员和母亲们了解严格的生酮饮食与哺乳相结合时的潜在风险。快速诊断和立即治疗至关重要。据我们所知，这是首例报告的与生酮饮食相关的危及生命的泌乳性酮症酸中毒病例，且患者每日摄入足够热量。
