title: Ketoacidosis associated with low-carbohydrate diet in a non-diabetic lactating woman: a case report.
abstract: BACKGROUND
  Non-diabetic ketoacidosis is a rare condition which can be caused by starvation. Lack of glucose can force the body into ketogenesis causing a metabolic acidosis. As previously reported in the literature, ketoacidosis might, on rare occasions, be caused by a diet with low carbohydrate content. However, to the best of our knowledge this is the first reported case in the literature of ketoacidosis, in a non-diabetic patient, associated with a combination of low carbohydrate, high fat diet and lactation.
  
  
  METHODS
  A healthy non-diabetic, 32-year old white woman started a low carbohydrate, high fat diet when she was breastfeeding her son of 10 months of age. After 10 days she was admitted to our hospital with nausea and vomiting and a serum pH of 7.20 and base excess of -19. Clinical signs and blood samples were compatible with ketoacidosis. She was given fluids intravenously and insulin. No anamnestic or clinical signs of diabetes were found. She recovered quickly and was discharged 3 days later.
  
  
  CONCLUSIONS
  Ketogenic diets like low carbohydrate, high fat may induce ketoacidosis. Lactation might further aggravate the condition and can perhaps even be the trigger into ketoacidosis. Health services should be aware of the risks associated with ketogenic diets, and be able to recognize this serious condition when it is presented.
authors.affiliation: Department of Gynaecology & Obstetrics, Helsingborg Hospital, SE-251 87, Helsingborg, Sweden. louise.vongeijer@skane.se.
authors.forename: Louise
authors.initials: L
authors.lastname: von Geijer
authors.affiliation: Department of Internal Medicine, Helsingborg Hospital, SE-251 87, Helsingborg, Sweden. magnus.ekelund@med.lu.se.
authors.forename: Magnus
authors.initials: M
authors.lastname: Ekelund
mesh_terms: D050528:Diet, Carbohydrate-Restricted / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007662:Ketosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D007774:Lactation; D014839:Vomiting / Q000209:etiology
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin