Similar symptoms in a person with alcohol use disorder may result from acute pancreatitis, methanol (wood alcohol) or ethylene glycol (antifreeze) poisoning or diabetic ketoacidosis. The doctor must exclude these other causes before diagnosing alcoholic ketoacidosis. Toxicity from methanol or ethylene glycol is an important differential diagnosis. Toxic metabolites of both substances result in severe metabolic acidosis with wide anion gap and wide osmolal https://ecosoberhouse.com/ gap.18 Neither, however, causes ketosis. Both cause abdominal pain, with marked central nervous system depression, but methanol toxicity results in visual impairment, while ethylene glycol toxicity results in crystalluria, oliguria, and renal failure. Carbohydrate and fluid replacement reverse this process by increasing serum insulin levels and suppressing the release of glucagon and other counterregulatory hormones and by providing metabolic substrate.
Differential diagnosis
The major cause of morbidity and mortality in patients diagnosed with AKA is under-recognition of concomitant diseases (that may have precipitated the AKA, to begin with). These include acute pancreatitis, gastrointestinal bleeding, and alcohol withdrawal. Mortality specifically due to AKA has been linked to the severity of serum beta-hydroxybutyric acid in some studies. If you chronically abuse alcohol, you probably don’t get as much nutrition as your body needs. Going on a drinking binge when your body is in a malnourished state may cause abdominal pain, nausea, or vomiting. Infection or other illnesses such as pancreatitis can also trigger alcoholic ketoacidosis in people with alcohol use disorder.
- In general, exogenous insulin is contraindicated in the treatment of AKA, because it may cause life-threatening hypoglycemia in patients with depleted glycogen stores.
- Fever was seen in only two patients, both with other likely underlying causes.
- This buildup of ketones can produce a life-threatening condition known as ketoacidosis.
- Seeking help as soon as symptoms arise reduces your chances of serious complications.
- Clinicians underestimate the degree of ketonemia if they rely solely on the results of laboratory testing.
- In general, the prognosis for a patient presenting with AKA is good as long as the condition is identified and treated early.
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One complication of alcoholic ketoacidosis is alcohol withdrawal. Your doctor and other medical professionals will watch you for symptoms of withdrawal. If your blood glucose level is elevated, your doctor may also perform a hemoglobin A1C (HgA1C) test.
Complicated Acidosis Presentations: When Is Diabetic Ketoacidosis Not Diabetic Ketoacidosis? A Case Series
Alcohol dehydrogenase (ADH), a cytosolic enzyme, metabolizes alcohol to acetaldehyde in hepatocytes. Acetaldehyde is metabolized further to acetic acid by aldehyde dehydrogenase. Both steps require alcoholic ketoacidosis smell the reduction of nicotinamide adenine dinucleotide (NAD+) to reduced nicotinamide adenine dinucleotide (NADH). Limiting the amount of alcohol you drink will help prevent this condition.
Alcohol-Related Metabolic Emergencies
Signs and symptoms of alcoholic ketoacidosis
