The syndrome of alcoholic ketoacidosis

Article Abstract:

Alcoholic ketoacidosis is the increase in acidity of the body fluids due to the accumulation of ketone bodies, which are products of fatty acid metabolism. It occurs in malnourished, chronic alcoholics. The clinical characteristics of the alcoholic ketoacidosis (AKA) syndrome were assessed in 74 affected patients. AKA was associated with metabolic or respiratory alkalosis, or excessive alkalinity of body fluids due to decreases in blood levels of bicarbonate or carbon dioxide. The syndrome was also associated with acidosis due to accumulation of chloride and lactic acid. The blood levels of acetoacetate, a type of ketone body, were increased in 96 percent of patients. Blood alcohol levels were abnormal in two thirds of tested patients, and included 40 percent with alcohol levels suggesting intoxication. Patients with AKA had abnormally low blood levels of sodium, potassium, phosphate, calcium, and magnesium; elevated blood glucose levels; symptoms of nausea, vomiting, and abdominal pain; rapid heart rate; rapid breathing; and abdominal tenderness. Changes in mental condition, fever, and low body temperature were rare, and indicated other underlying illnesses. These findings show that AKA commonly occurs in malnourished chronic alcoholics. The biochemical changes associated with the AKA syndrome reflect ketoacidosis, depletion of tissue fluid, alcohol withdrawal, pain, bacterial infection of the blood, and severe liver disease. The AKA syndrome is a complex but treatable disorder with a low death rate. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Risk factors, Alcoholism, Metabolism, Ketoacidosis, Diabetic ketoacidosis

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Irreversible complete heart block in Lyme disease

Article Abstract:

Lyme disease is an inflammatory disease that affects the joints and causes a number of symptoms and complications. It is caused by a bacterium (a spirochete) that can be transferred to humans by tick bites. Sometimes the complications involve the heart, and include atrioventricular (AV) block, which is a blockage of the electrical impulses controlling contraction that travel through the AV node in the heart. Normally in Lyme patients, this problem only continues for a short time. This study examined the case of a 20-year-old woman with Lyme disease who had an AV block. She entered the hospital and the block was discovered. Tests for other causes than Lyme disease were negative. Treatment was begun, but the block continued despite six weeks of treatment. An artificial pacemaker was then implanted. Tests done a year later showed the block was persisting. This is the first case reported in which AV block that appeared to be associated with Lyme disease was irreversible. Although other causes cannot be completely ruled out, it appears that Lyme disease might cause irreversible AV block. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Causes of, Complications and side effects, Lyme disease, Heart conduction system, Heart block

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