Gall Alexander J, Duncan Robert, Badshah Amit
Weston General Hospital, Weston-super-Mare, UK
Weston General Hospital, Weston-super-Mare, UK.
Clin Med (Lond). 2020 May;20(3):298-300. doi: 10.7861/clinmed.2020-0012.
Starvation ketoacidosis (SKA) represents one of three metabolic acidoses caused by the accumulation of ketone bodies within the bloodstream. While easily treated, it is a diagnosis that can be easily missed in patients with an unexplained metabolic acidosis.In this case report, we discuss two patients presenting with a starvation ketoacidosis and psychiatric illness. This link between SKA and psychiatric disease is especially pertinent as this is a cohort of patients who may not be able to give an accurate history, which can potentially lead to a delay in diagnosis and treatment.Furthermore, the patient cohort described here have higher rates of alcohol dependence and are therefore at risk of alcoholic ketoacidosis. It is important to recognise that these conditions may coexist and should be managed as such, with thiamine prior to carbohydrate replacement in all at-risk patients.
饥饿性酮症酸中毒（SKA）是由血液中酮体蓄积引起的三种代谢性酸中毒之一。虽然易于治疗，但在患有不明原因代谢性酸中毒的患者中，这一诊断很容易被漏诊。在本病例报告中，我们讨论了两名患有饥饿性酮症酸中毒和精神疾病的患者。SKA与精神疾病之间的这种联系尤为相关，因为这组患者可能无法提供准确的病史，这可能会导致诊断和治疗的延迟。此外，此处描述的患者群体酒精依赖率较高，因此有发生酒精性酮症酸中毒的风险。必须认识到，这些情况可能同时存在，应如此进行处理，在所有高危患者中，补充碳水化合物之前先补充硫胺素。
