See Pract Diab Int 2001; 18(7) 239-40 for 2 cases of 'euglycaemic DKA'
Rob
>Suggest that you check for ketones on the original sample.
>We had a very similar case a few weeks ago.
>This has previously been reported as normoglycaemic diabetic ketoacidosis
>My view is that the word diabetic is superfluous, since I think it is
>starvation ketosis.
>The starvation is probably acute rather than chronic, since the urea is not
>as low as one might expect if more chronic.
>
>with best wishes
>
>Richard
>
>Richard Mainwaring-Burton
>Consultant Biochemist
>Queen Mary's Hospital
>Sidcup, Kent
>DA14 6LT
>020-8308-3084
>
>
>-----Original Message-----
>From: Curtis, Gail [mailto:[log in to unmask]]
>Sent: 05 February 2004 09:49
>To: [log in to unmask]
>Subject: Severe metabolic acidosis
>
>
>Help please with a severe metabolic acidosis.
>
>35 yr old lady, 23 weeks pregnant (reformed drug abuser). 7 day history of
>protracted vomitting. Admitted to A/E with vomitting and breathlessness,
>found to have a profound metabolic acidosis. Admission results-
>
>Na 129 mmol/l
>K 3.7 mmol/l
>Cl 98 mmol/l
>HCO3 7 mmol/l
>urea 5.1 mmol/l
>creat 122 umol/l
>AGAP 24 mmol/l
>
>glucose 5.0 mmol/l
>ethanol undetectable
>osmo 283 mosmol/kg
>lactate 0.5 mmol/l
>para/sal undetectable
>
>pH 7.27
>pCO2 4.2 kPa
>pO2 3.1 kPa
>std HCO3 15
>base XS -11.7
>
>Given iv saline - and 24 hours later, Na 137, HCO3 up to 16, urea down to
>2.2 and creat down to 58.
>
>Any suggestions?
>
>Thanks
>Gail
>
>Gail Curtis
>Principal Biochemist
>Department of Chemical Pathology
>Ysbyty Glan Clwyd
>
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