title: Acute intractable vomiting and severe ketoacidosis secondary to the Dukan Diet©.
abstract: BACKGROUND
  The benefits of low-carbohydrate, high-protein diets, such as the Dukan Diet©, are well documented, whereas reported adverse effects are rare in literature. Such diets mimic starvation states in that they promote the breakdown of fat and the production of ketones secondary to fatty acid metabolism. In fact, one measure of the effectiveness of such diets is the presence of ketosis. To our knowledge, there have been no reported cases of ketoacidosis resulting from the Dukan Diet.
  
  
  OBJECTIVE
  The purpose of this case report is to illustrate the importance of a detailed dietary history in patients with severe ketoacidosis secondary to the Dukan Diet and suggest treatment that may allow outpatient management.
  
  
  METHODS
  A 42-year-old Iranian woman with no prior medical problems presented with 10 h of intractable nausea and vomiting secondary to ketoacidosis 2 days after starting the Dukan Diet.
  
  
  CONCLUSIONS
  Although rare, ketoacidosis secondary to a low-carbohydrate, high-protein diet can have serious complications if untreated. Clinical suspicion should arise in any patient presenting with intractable nausea and vomiting after starting a diet such as the Dukan Diet. Early recognition and intervention is essential to quicken patient recovery and outpatient management.
authors.affiliation: Medical College of Georgia at Georgia Regents University, Augusta, Georgia.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Freeman
authors.affiliation: Division of Emergency Medicine, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Blake
authors.initials: B
authors.lastname: Willis
authors.affiliation: Division of Emergency Medicine, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Diann M
authors.initials: DM
authors.lastname: Krywko
mesh_terms: D000208:Acute Disease; D000328:Adult; D050528:Diet, Carbohydrate-Restricted / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007662:Ketosis / Q000209:etiology*; D014839:Vomiting / Q000209:etiology*
keywords: ketoacidosis; ketonuria; low-carbohydrate diet; nausea; vomiting