Display options
Cite
Sloan G, Ali A, Webster J. A rare cause of metabolic acidosis: ketoacidosis in a non-diabetic lactating woman. Endocrinol Diabetes Metab Case Rep. 2017;2017doi: 10.1530/EDM-17-0073.
Sloan, G., Ali, A., & Webster, J. (2017). A rare cause of metabolic acidosis: ketoacidosis in a non-diabetic lactating woman. Endocrinology, diabetes & metabolism case reports, 2017. https://doi.org/10.1530/EDM-17-0073
Sloan, Gordon, et al. "A rare cause of metabolic acidosis: ketoacidosis in a non-diabetic lactating woman." Endocrinology, diabetes & metabolism case reports vol. 2017 (2017). doi: https://doi.org/10.1530/EDM-17-0073
Sloan G, Ali A, Webster J. A rare cause of metabolic acidosis: ketoacidosis in a non-diabetic lactating woman. Endocrinol Diabetes Metab Case Rep. 2017 Sep 04;2017. doi: 10.1530/EDM-17-0073. eCollection 2017. PMID: 28924478; PMCID: PMC5592701.
Copy Download .nbib Format: NLM
Share it on

Endocrinol Diabetes Metab Case Rep. 2017 Sep 04;2017. doi: 10.1530/EDM-17-0073. eCollection 2017.

A rare cause of metabolic acidosis: ketoacidosis in a non-diabetic lactating woman.

Endocrinology, diabetes & metabolism case reports

Gordon Sloan, Amjad Ali, Jonathan Webster

Affiliations

  1. Department of Diabetes and Endocrinology, Sheffield Teaching Hospital, Sheffield, UK.

PMID: 28924478 PMCID: PMC5592701 DOI: 10.1530/EDM-17-0073

Abstract

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.

LEARNING POINTS: Ketoacidosis in the lactating woman is a rare cause of raised anion gap metabolic acidosis.Low carbohydrate intake, starvation, intercurrent illness or a combination of these factors could put breastfeeding women at risk of ketoacidosis.Ketoacidosis in the lactating woman has been shown to resolve rapidly with sufficient carbohydrate intake and intravenous dextrose.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.

References

  1. J Indiana State Med Assoc. 1983 Jun;76(6):392-3 - PubMed
  2. Diabetes Metab Res Rev. 1999 Nov-Dec;15(6):412-26 - PubMed
  3. N Am J Med Sci. 2015 Jun;7(6):291-4 - PubMed
  4. Nutr J. 2015 Nov 04;14:117 - PubMed
  5. Case Rep Crit Care. 2014;2014:906283 - PubMed
  6. Clin Med (Lond). 2011 Oct;11(5):473-5 - PubMed
  7. Emerg Med J. 2006 Jun;23(6):417-20 - PubMed
  8. J Med Case Rep. 2015 Oct 01;9:224 - PubMed
  9. Annu Rev Nutr. 1988;8:63-79 - PubMed
  10. Ann Intensive Care. 2011 Jul 06;1(1):23 - PubMed
  11. Am J Clin Nutr. 2009 Jun;89(6):1821-7 - PubMed
  12. Diabetes Care. 1982 Jan-Feb;5(1):47-9 - PubMed
  13. A A Case Rep. 2016 Aug 15;7(4):81-4 - PubMed
  14. J Emerg Med. 2008 Nov;35(4):385-7 - PubMed
  15. Clin Endocrinol Metab. 1983 Jul;12(2):359-79 - PubMed
  16. Am J Physiol Endocrinol Metab. 2009 Oct;297(4):E879-88 - PubMed
  17. Postgrad Med J. 2003 Aug;79(934):454-7 - PubMed
  18. Perm J. 2016 Spring;20(2):71-3 - PubMed
  19. BMJ Case Rep. 2012 Mar 08;2012:null - PubMed
  20. Diabetes Care. 2015 Sep;38(9):1638-42 - PubMed
  21. NDT Plus. 2009 Aug;2(4):278-9 - PubMed

Publication Types