The Permanente Medical Group Inc, Sacramento, CA.
Perm J. 2021 Jan;25:1. doi: 10.7812/TPP/20.162.
Ketoacidosis is a metabolic condition caused by the buildup of ketone bodies. The most common causes are diabetes, alcoholism, and starvation. This is a case of a lactating mother on a ketogenic diet who developed a community-acquired pneumonia and then went into life-threatening ketoacidosis.
A 32-year-old, lactating, 8-week-postpartum woman presented to the hospital complaining of nausea, vomiting, rhinorrhea, and cough. She had no history of diabetes or of alcohol or drug use but reported following a ketogenic diet and was found to have a pneumonia. The pneumonia was treated with antibiotics, and the acidosis resolved with a dextrose solution.
We report the case of a mother who, while lactating and losing weight on a ketogenic diet, developed a pneumonia and then went into ketoacidosis. Physicians should be aware that patients on the ketogenic diet are at risk for life-threatening acidosis, especially if they develop a second and/or third stressor or energy requirement on top of the low-carbohydrate diet. This case and those reviewed in the literature indicate that ketogenic diets may not be safe during lactation and could be associated with increased morbidity.
酮症酸中毒是由酮体堆积引起的代谢紊乱。最常见的原因是糖尿病、酗酒和饥饿。这是一位哺乳期母亲的病例,她采用生酮饮食,患上社区获得性肺炎,随后发生危及生命的酮症酸中毒。
一位 32 岁、哺乳期、产后 8 周的女性因恶心、呕吐、流涕和咳嗽到医院就诊。她没有糖尿病史,也没有饮酒或吸毒史,但报告称正在进行生酮饮食,并被发现患有肺炎。肺炎用抗生素治疗,酸中毒通过葡萄糖溶液得到纠正。
我们报告了一位母亲的病例,她在哺乳期进行生酮饮食以减轻体重,随后患上肺炎,继而发生酮症酸中毒。医生应意识到,进行生酮饮食的患者有发生危及生命的酸中毒的风险,尤其是在他们除了低碳水化合物饮食之外,还面临第二个和/或第三个应激源或能量需求时。本病例以及文献中回顾的病例表明,生酮饮食在哺乳期可能不安全,并可能与更高的发病率相关。