Acidocétose sévère après un régime cétogène chez une jeune femme allaitante non-diabétique

Abstract

Ketogenic diet, used in therapeutics in refractory epilepsies, is in general a low-calorie diet, with low-carbohydrate, high-fat and adequate protein intake, inducing ketosis. It use has spread to the general population because it helps achieve rapid weight loss. Ketosis induced by this diet may in some cases progress to ketoacidosis, for example during acute illness or in specific settings where energy expenditure is increased such as breastfeeding or high intensity physical activity. We report the case of a 36-years-old lactating woman without diabetes who developed at six weeks postpartum severe metabolic acidosis. This patient, while breastfeeding exclusively, had resumed intensive physical activity and had been on a ketogenic diet for ten days. A filling with salty then glucose serum and a diversified progressive replenishment allowed a rapid normalization of acid-base balance and digestive symptomatology. The diagnosis of lactation ketoacidosis should be suspected in cases of severe metabolic acidosis in young women without diabetes who are breastfeeding and who have used a ketogenic diet in order to quickly lose their pregnancy pounds.