Severe Alkalemia, Hyponatremia, and Diabetic Ketoacidosis in an Alcoholic Man

Abstract

A 52-year-old Native American man presented with days of vomiting, hematemesis, weakness, fatigue, polyuria with polydipsia, and dull midepigastric pain that radiated to the left upper quadrant. He admitted to a 10-day alcoholic beverage binge, as well as 4 days of little or no solid food intake. A medical history included 30 years of alcohol abuse, adult-onset diabetes mellitus, upper gastrointestinal tract bleeding, and hyponatremia 16 months earlier with a serum sodium level of 125 mEq/L. His medications included chlorpropamide and occasional aspirin use.