Alcoholic ketoacidosis as the cause of repeated episodes of severe metabolic acidosis.

Abstract

The diagnosis of alcoholic ketoacidosis (AKA) is made surprisingly rarely in Britain. There have been only two reports in the UK literature.l? In contrast, it is commonly encountered in the USA, with many reports since its first description in 1940.3 The apparent rarity of the condition may be due to a number of potentially confounding factors: the patient may not actually be acidotic, there may not be detectable ethanol in the blood, and the commonly used urine dipstick tests for ketones are insensitive to P-hydroxybutyrate. It is important to distinguish AKA from other conditions with high anion and osmolal gaps that are due to the presence of unusual alcohols, because accepted therapy for the latter could be deleterious if the correct diagnosis was AKA.