Key result
Alcoholic ketoacidosis presents as wide-anion-gap metabolic acidosis and requires direct β-hydroxybutyrate measurement for diagnosis.
Case Report (n=1)
Highlights the importance of directly measuring beta-hydroxy butyrate and maintaining a high index of suspicion for alcoholic ketoacidosis in patients with heavy alcohol consumption.
Direct β-hydroxybutyrate measurement aids AKA diagnosis in wide-gap acidosis; case report leaves open prospective validation.
Alcoholic ketoacidosis (AKA) is an under-recognized condition that is seen in alcoholics following abrupt cessation or reduction of alcohol consumption. Symptoms and routine laboratory results are non-specific. The diagnosis of AKA is complicated by the fact that standard tests for ketone detection do not detect β-hydroxy butyrate, the primary ketone present in AKA, and must be measured directly. Patients may have a mixed acid base disorder with a primary wide-anion-gap metabolic acidosis, and concurrent metabolic alkalosis and respiratory alkalosis (triple acid base imbalance). A high index of suspicion should be maintained in all patients with a history of heavy alcohol consumption.
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Navaravong et al. (2009) conducted a case report in Alcoholic ketoacidosis (n=1). Abrupt cessation or reduction of alcohol consumption was evaluated. Alcoholic ketoacidosis following abrupt cessation of alcohol consumption presents with a wide-anion-gap metabolic acidosis and requires direct measurement of β-hydroxy butyrate for diagnosis.
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