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Starvation Ketoacidosis

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Starvation Ketoacidosis: A Cause Of Severe Anion Gap Metabolic Acidosis In Pregnancy

Pregnancy is a diabetogenic state characterized by relative insulin resistance, enhanced lipolysis, elevated free fatty acids and increased ketogenesis. In this setting, short period of starvation can precipitate ketoacidosis. This sequence of events is recognized as "accelerated starvation." Metabolic acidosis during pregnancy may have adverse impact on fetal neural development including impaired intelligence and fetal demise. Short periods of starvation during pregnancy may present as severe anion gap metabolic acidosis (AGMA). We present a 41-year-old female in her 32nd week of pregnancy, admitted with severe AGMA with pH 7.16, anion gap 31, and bicarbonate of 5 mg/dL with normal lactate levels. She was intubated and accepted to medical intensive care unit. Urine and serum acetone were positive. Evaluation for all causes of AGMA was negative. The diagnosis of starvation ketoacidosis was established in absence of other causes of AGMA. Intravenous fluids, dextrose, thiamine, and folic acid were administered with resolution of acidosis, early extubation, and subsequent normal delivery of a healthy baby at full term. Rapid reversal of acidosis and favorable outcome are achieved with Continue reading >>

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Popular Questions

  1. Niquie

    Just wondering if anyone gets dull and burning pain in one of their kidneys when they are in ketosis? I've been going really great this week on induction (second time over )but I have an annoying dull pain and burn in my right side and mid to lower back.
    I've also started jogging so I don't know if its muscular but when it got bad this evening, I was reaching a dark purple on the tester strips which I have never had at all since I originally started Atkins last Feb.
    Just wondering if anyone has had similar problem and don't worry - I will go to the Doc!
    Appreciate any input you guys might have.

  2. anthonyc

    how much water do you drink per day

  3. Niquie

    On average about 4-6 glasses a day along with 2 herbal teas and 3 decaff coffees. Something else - I seem to be tasting salt in everything, what is up with that? I cant even stomach a piece of bacon cause the salt is making me sick. Yuk !!! ( I normally lurv salt - in moderation of course)

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