title: Short-term starvation with a near-fatal asthma attack induced ketoacidosis in a nondiabetic pregnant woman: A case report.
abstract: Life-threatening refractory metabolic acidosis due to starvation ketoacidosis is rarely reported, even among nondiabetic pregnant women, and may be overlooked. Furthermore, stressful situations may increase the acidosis severity.In the present case, a nondiabetic multiparous woman was admitted for a near-fatal asthma attack and vomiting during the third trimester of pregnancy. She was intubated and rapidly developed high anion gap metabolic acidosis. We diagnosed the patient with starvation ketoacidosis based on vomiting with concomitant periods of stress during pregnancy and the absence of other causes of high anion gap metabolic acidosis. She responded poorly to standard treatment, although the ketoacidosis and asthma promptly resolved after an emergency caesarean section. The patient and her baby were safely discharged.Short-term starvation, if it occurs during periods of stress and medication, can result in life-threatening ketoacidosis, even among nondiabetic women during the third trimester of pregnancy. Awareness of this condition may facilitate prompt recognition and proactive treatment for dietary and stress control, and emergent interventions may also improve outcomes.
authors.affiliation: aDepartment of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center bDepartment of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center cDivision of Pulmonary and Critical Care, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Kuang-Yu
authors.initials: KY
authors.lastname: Wei
authors.forename: Shan-Yueh
authors.initials: SY
authors.lastname: Chang
authors.forename: Sheng-Huei
authors.initials: SH
authors.lastname: Wang
authors.forename: Her-Young
authors.initials: HY
authors.lastname: Su
authors.forename: Chen-Liang
authors.initials: CL
authors.lastname: Tsai
mesh_terms: D000328:Adult; D001249:Asthma / Q000150:complications*; D005260:Female; D006801:Humans; D007662:Ketosis / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications; D012720:Severity of Illness Index; D013217:Starvation / Q000150:complications*; D013997:Time Factors