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Media type:
E-Article
Title:
A rare cause of metabolic acidosis: ketoacidosis in a non-diabetic lactating woman
Contributor:
Sloan, Gordon;
Ali, Amjad;
Webster, Jonathan
imprint:
Bioscientifica, 2017
Published in:Endocrinology, Diabetes & Metabolism Case Reports
Language:
Not determined
DOI:
10.1530/edm-17-0073
ISSN:
2052-0573
Origination:
Footnote:
Description:
<jats:title>Summary</jats:title><jats:p>Ketoacidosis occurring during lactation has been described infrequently. The condition is incompletely understood, but it appears to be associated with a combination of increased metabolic demands during lactation, reduction in carbohydrate intake and acute illness. We present a case of a 27-year-old woman, 8 weeks post-partum, who was exclusively breastfeeding her child whilst following a low carbohydrate diet. She developed gastroenteritis and was unable to tolerate an oral diet for several days. She presented with severe metabolic acidosis on admission with a blood 3-hydroxybutyrate of 5.4 mmol/L. She was treated with intravenous dextrose and intravenous sodium bicarbonate, and given dietary advice to increase her carbohydrate intake. She made a rapid and full recovery. We provide a summary of the common causes of ketoacidosis and compare our case with other presentations of lactation ketoacidosis.</jats:p><jats:sec><jats:title>Learning points:</jats:title><jats:list list-type="bullet"><jats:list-item><jats:p>Ketoacidosis in the lactating woman is a rare cause of raised anion gap metabolic acidosis.</jats:p></jats:list-item><jats:list-item><jats:p>Low carbohydrate intake, starvation, intercurrent illness or a combination of these factors could put breastfeeding women at risk of ketoacidosis.</jats:p></jats:list-item><jats:list-item><jats:p>Ketoacidosis in the lactating woman has been shown to resolve rapidly with sufficient carbohydrate intake and intravenous dextrose.</jats:p></jats:list-item><jats:list-item><jats:p>Early diagnosis and prompt treatment are essential because the condition is reported to be reversible with a low chance of recurrence with appropriate dietary advice.</jats:p></jats:list-item></jats:list></jats:sec>