Chakravartty Akash, Patel Prachi B, Mishra Pranjal, Akilla Rishav, Luther Vera
Neurology, Wake Forest Baptist Medical Center, Winston Salem, USA.
Internal Medicine, Philadelphia College of Osteopathic Medicine, Atlanta, USA.
Cureus. 2022 Dec 15;14(12):e32551. doi: 10.7759/cureus.32551. eCollection 2022 Dec.
Acetone is one of the three main types of ketone bodies that can be found in ketoacidosis, along with acetoacetate, and beta-hydroxybutyrate. Any of these three ketone bodies can be found in the blood after the natural breakdown of fatty acids in diabetes, starvation, or alcoholic ketoacidosis. However, a patient can also develop acetone poisoning from ingestion of common household products such as nail polish removers, paint removers, isopropyl alcohol, or other detergents and cleaners. Ingestion is usually accidental in adults and children and can lead to severe damage to the liver, heart, nervous system, and kidneys. In rare cases, large amounts of ingestion can lead to life-threatening conditions or death. Our case reports a man with a history of alcoholic cirrhosis status post liver transplantation, who unintentionally ingested acetone, mistaking the contents of small bottles for vodka. The patient presented with several syncopal episodes, anion gap metabolic acidosis, transaminitis with hyperbilirubinemia, and pancreatitis.
丙酮是酮症酸中毒中可发现的三种主要酮体之一，另外两种是乙酰乙酸和β-羟基丁酸。在糖尿病、饥饿或酒精性酮症酸中毒时，脂肪酸自然分解后，血液中可发现这三种酮体中的任何一种。然而，患者也可能因摄入普通家用产品（如洗甲水、脱漆剂、异丙醇或其他洗涤剂和清洁剂）而发生丙酮中毒。成人和儿童的摄入通常是意外的，可能导致肝脏、心脏、神经系统和肾脏的严重损害。在罕见情况下，大量摄入可导致危及生命的情况或死亡。我们的病例报告了一名肝移植术后酒精性肝硬化病史的男性，他误将小瓶中的内容物当作伏特加而无意中摄入了丙酮。该患者出现了几次晕厥发作、阴离子间隙代谢性酸中毒、伴有高胆红素血症的转氨酶升高和胰腺炎。
