L. Hui and L. Shuying (2018). Acute starvation ketoacidosis in pregnancy with severe hypertriglyceridemia: A case report. Medicine, 97(19), e0609. https://doi.org/10.1097/MD.0000000000010609

PubMed 29742696

[Abstract]
RATIONALE: Pregnant women are more prone to ketosis due to the relative insulin resistance, accelerated lipolysis and increased free fatty acids.

PATIENT CONCERNS: We report a pregnant woman with hyperlipidemia, who experienced severe metabolic acidosis after a short period of starvation.

DIAGNOSES: Based on her clinical symptoms, exclusion diagnosis and therapeutic diagnosis, her condition was diagnosed as starvation ketoacidosis.

INTERVENTIONS: An emergency caesarean section under general anesthesia was implemented 2 hours after her admission. The metabolic acidosis was treated with fluid resuscitation using compound sodium lactate, bicarbonate, and 5% dextrose together with insulin 6U.

OUTCOMES: Both mother and baby were discharged clinically well.

LESSONS: Starvation ketoacidosis may happen in special patient who was in pregnancy and with severe hypertriglyceridemia, after just one day fasting and vomiting.