Ugeskr Læger 2014;176:V05140275
Starvation is a rare cause of metabolic ketoacidosis
A 79-year-old woman with no medical history was admitted under the diagnosis of stroke. Two months prior she had a fractured tibia, complicated by osteomyelitis. Physical examination showed dehydration and malnourishment. Chest X-ray revealed pneumonia and laboratory data revealed signs of infection, dehydration and normoglycaemic metabolic acidosis with elevated P-3-hydroxybutyrate. The case presents a starvation (weight loss ~ 13 kg) and infection induced non-diabetic metabolic ketoacidosis treated with intravenous supplementation of isotonic saline, potassium, bicarbonate and insulin.