A patient who developed a significaant ketoacidosis [pH 7.06, increased anion gap metabolic acidosis, venous plasma beta hydroxybutyrate 5.0mmol/L ]on alpha interferon and interleukin2 for renal cell carcinoma. Other medication Protium and fluconazole.Lactate normal, no salicylate, paracetamol or salicylate detected, no ethanol/methanol/ethylene glycol. No previous diabetes. Peak blood sugar following admission 8mmol/L. Had been anorexic for 3 days with little food ingestion prior to admission.The hydroxybutyrate seems a good deal higher than one would expect for a period of starvation. Is anyone aware of any link between interleukin or alpha interferon and ketoacidosis. The manufacturers datasheet refers to an effect of interferon on 'oxidative metabolism' but does not elaborate further
Thanks
Maurice O'Kane
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