Alcoholic Ketoacidosis Endocrine and Metabolic Disorders MSD Manual Professional Edition

Several mechanisms are responsible for dehydration, including protracted vomiting, decreased fluid intake, and inhibition of antidiuretic hormone secretion by ethanol. Volume depletion is a strong stimulus to the sympathetic nervous system and is responsible for elevated cortisol and growth hormone levels. Typically, an alcohol binge leads to vomiting and the cessation of alcohol or food intake for ≥ 24 hours. During this period of starvation, vomiting continues and abdominal pain develops, leading the patient to seek medical attention.

On arrival, he is tachycardic and tachypneic, and physical examination findings include dry mucous membranes, decreased sakin turgor, epigastric tenderness, and a tremor in both hands. Laboratory studies show a serum bicarbonate of 10 mEq/L, an anion gap of 30, a serum glucose of 95 mg/dL, a lactic acidosis with pH 7.2, hypophosphatemia, and trace ketonuria. He denies a history of diabetes mellitus, ingestion of any toxic alcohols, or recent illness. He was also placed on CIWA protocol while in the ED and received 1 mg of oral lorazepam.

Symptoms of Alcoholic Ketoacidosis

He was admitted to the internal medicine service for continued management. On hospital day one, after continued fluid resuscitation with 5% dextrose in half-normal saline, the patient’s anion gap closed, his INR decreased to 5.9, and he did not require lorazepam for treatment of alcohol withdrawal. By hospital day two, the patient’s INR normalized to therapeutic range and his warfarin was restarted.

Similar symptoms in a person with alcohol use disorder Alcohol Use Alcohol (ethanol) is a depressant (it slows down brain and nervous system functioning). Consuming large amounts rapidly or regularly can cause health problems, including organ damage, coma,… Read more may result from acute pancreatitis Acute Pancreatitis Acute pancreatitis is sudden inflammation of the pancreas that may be mild or life threatening but https://ecosoberhouse.com/ usually subsides. Gallstones and alcohol abuse are the main causes of acute pancreatitis. Read more , methanol (wood alcohol) or ethylene glycol (antifreeze) poisoning or diabetic ketoacidosis Diabetic Ketoacidosis Diabetic ketoacidosis is an acute complication of diabetes that occurs mostly in type 1 diabetes mellitus. Symptoms of diabetic ketoacidosis include nausea, vomiting, abdominal pain, and a characteristic…

When to Contact a Medical Professional

Antiemetics such as ondansetron or metoclopramide may also be given to control nausea and vomiting. All alcoholic patients presenting with acute illness should be offered contact with addiction services prior to or following discharge wherever possible. All chronic alcohol misusers attending the ED should receive intravenous B vitamins as recommended by The Royal College of Physicians.23 alcoholic ketoacidosis Strenuous efforts must be made to exclude concomitant pathology. DiscussionThis case highlights the importance of diagnosing patients with AKA and providing the appropriate treatment. With early diagnosis and appropriate treatment, patients improve rapidly and serious complications are prevented. Treatment may involve fluids (salt and sugar solution) given through a vein.