title: Abrupt alcohol withdrawal: another cause of ketoacidosis often forgotten.
abstract: A 54-year-old woman was admitted to our emergency department for acute confusion. She had only a history of chronic alcohol abuse with an abrupt withdrawal. The initial diagnosis was delirium tremens. Biological findings, however, showed a severe degree of metabolic acidosis (plasma pH 7.07, bicarbonate 9.6 mmol/l) with an increased anion gap (39.6 mmol/l). Serum glucose was normal and ketonuria was present. Ketoacidosis was also suspected and treated by fluid infusion and delivery of glucose with a favorable outcome. Differential ketoacidosis is discussed in the emergency room.
authors.affiliation: Department of Emergency and Intensive Care, Hôpital de Hautepierre, Strasbourg, France. pascal.bilbault@chru-strasbourg.fr
authors.forename: Pascal
authors.initials: P
authors.lastname: Bilbault
authors.forename: Jonathan
authors.initials: J
authors.lastname: Levy
authors.forename: Stephane
authors.initials: S
authors.lastname: Vinzio
authors.forename: Vincent
authors.initials: V
authors.lastname: Castelain
authors.forename: Francis
authors.initials: F
authors.lastname: Schneider
mesh_terms: D000138:Acidosis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D000430:Alcohol Withdrawal Delirium / Q000175:diagnosis; D003681:Dehydration / Q000150:complications; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007657:Ketone Bodies / Q000652:urine*; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology; D013217:Starvation / Q000150:complications; D013375:Substance Withdrawal Syndrome / Q000652:urine*
chemical_list: D007657:Ketone Bodies