title: Ketosis and cardiac failure: common signs of a single condition.
abstract: The metabolic effects of chronic alcohol abuse can induce a broad spectrum of disorders. We describe the case of an initially unidentified alcoholic, poorly nourished woman who presented with ketoacidosis. She developed severe cardiac failure, which did not respond to classical treatment. The administration of intravenous thiamine resulted in an impressive recovery of cardiac function. Laboratory examinations confirmed the diagnosis of alcoholic ketoacidosis and cardiac beriberi. The clinical entity and treatment of these two uncommon disorders are discussed. If recognized early both diseases (and their combination) are fully reversible.
authors.affiliation: Critical Care Department, Akademisch Ziekenhuis Vrije Universiteit Brussel, Brussels, Belgium. marc.diltoer@az.vub.ac.be
authors.forename: Marc W
authors.initials: MW
authors.lastname: Diltoer
authors.forename: Joris
authors.initials: J
authors.lastname: Troubleyn
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Lauwers
authors.forename: Simone
authors.initials: S
authors.lastname: De Wijngaard
authors.forename: Martine J
authors.initials: MJ
authors.lastname: Vercammen
authors.forename: Ives
authors.initials: I
authors.lastname: Hubloue
authors.forename: Luc P
authors.initials: LP
authors.lastname: Huyghens
mesh_terms: D000437:Alcoholism / Q000150:complications* / Q000175:diagnosis; D001602:Beriberi / Q000175:diagnosis / Q000188:drug therapy; D002100:Cachexia / Q000209:etiology / Q000628:therapy; D003937:Diagnosis, Differential; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007662:Ketosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000379:methods; D012772:Shock, Septic / Q000175:diagnosis; D013831:Thiamine / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D013831:Thiamine