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Diet-induced Ketoacidosis in a Non-diabetic: A Case Report

INTRODUCTION: Anion gap metabolic acidosis is a common disorder seen in the emergency department. The differential can include toxicological, renal, endocrine, infectious, and cardiogenic disorders. Ketosis, however, is one of the rarer causes of metabolic acidosis seen by the emergency physician in...

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Detalles Bibliográficos
Autores principales: Slade, Sam, Ashurst, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220017/
https://www.ncbi.nlm.nih.gov/pubmed/32426688
http://dx.doi.org/10.5811/cpcem.2020.2.44736
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author Slade, Sam
Ashurst, John
author_facet Slade, Sam
Ashurst, John
author_sort Slade, Sam
collection PubMed
description INTRODUCTION: Anion gap metabolic acidosis is a common disorder seen in the emergency department. The differential can include toxicological, renal, endocrine, infectious, and cardiogenic disorders. Ketosis, however, is one of the rarer causes of metabolic acidosis seen by the emergency physician in developed nations. CASE REPORT: A 53-year-old female presented after starting a low-carbohydrate ketogenic diet for weight loss. She reported xerostomia, nausea with abdominal pain and a 17-pound weight loss over the previous 22 days. Labs revealed an anion-gap metabolic acidosis with ketosis. She was treated with 5% dextrose in normal saline and a sliding scale insulin coverage. Her anion gap corrected during her hospital course and was discharged on hospital day three. DISCUSSION: The ketogenic diet typically consists of a high-fat, adequate protein and low carbohydrate diet that has previously been thought to be relatively safe for weight loss. However, when carbohydrates are completely removed from the diet an overproduction of ketones bodies results in ketoacidosis. Treatment should be aimed at halting the ketogenic process and patient education. CONCLUSION: Although rarely included in the differential for metabolic acidosis, diet-induced ketosis should be included by the emergency physician when faced with a patient who recently changed their eating patterns.
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spelling pubmed-72200172020-05-18 Diet-induced Ketoacidosis in a Non-diabetic: A Case Report Slade, Sam Ashurst, John Clin Pract Cases Emerg Med ACOEP Case Report INTRODUCTION: Anion gap metabolic acidosis is a common disorder seen in the emergency department. The differential can include toxicological, renal, endocrine, infectious, and cardiogenic disorders. Ketosis, however, is one of the rarer causes of metabolic acidosis seen by the emergency physician in developed nations. CASE REPORT: A 53-year-old female presented after starting a low-carbohydrate ketogenic diet for weight loss. She reported xerostomia, nausea with abdominal pain and a 17-pound weight loss over the previous 22 days. Labs revealed an anion-gap metabolic acidosis with ketosis. She was treated with 5% dextrose in normal saline and a sliding scale insulin coverage. Her anion gap corrected during her hospital course and was discharged on hospital day three. DISCUSSION: The ketogenic diet typically consists of a high-fat, adequate protein and low carbohydrate diet that has previously been thought to be relatively safe for weight loss. However, when carbohydrates are completely removed from the diet an overproduction of ketones bodies results in ketoacidosis. Treatment should be aimed at halting the ketogenic process and patient education. CONCLUSION: Although rarely included in the differential for metabolic acidosis, diet-induced ketosis should be included by the emergency physician when faced with a patient who recently changed their eating patterns. University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine 2020-04-23 /pmc/articles/PMC7220017/ /pubmed/32426688 http://dx.doi.org/10.5811/cpcem.2020.2.44736 Text en Copyright: © 2020 Slade et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/
spellingShingle ACOEP Case Report
Slade, Sam
Ashurst, John
Diet-induced Ketoacidosis in a Non-diabetic: A Case Report
title Diet-induced Ketoacidosis in a Non-diabetic: A Case Report
title_full Diet-induced Ketoacidosis in a Non-diabetic: A Case Report
title_fullStr Diet-induced Ketoacidosis in a Non-diabetic: A Case Report
title_full_unstemmed Diet-induced Ketoacidosis in a Non-diabetic: A Case Report
title_short Diet-induced Ketoacidosis in a Non-diabetic: A Case Report
title_sort diet-induced ketoacidosis in a non-diabetic: a case report
topic ACOEP Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220017/
https://www.ncbi.nlm.nih.gov/pubmed/32426688
http://dx.doi.org/10.5811/cpcem.2020.2.44736
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