[Ethanol, sugar, acid and coma]

Abstract

We report on a 46-year-old female patient with chronic alcoholism, who presented with a severe metabolic acidosis and an increased anion gap despite repeated vomiting. In face of a dramatically increased serum-beta-hydroxybutyrate and after ruling out more common causes of acidosis, we were able to diagnose an alcoholic ketoacidosis. The epidemiology, pathophysiology, clinics and treatment of this often forgotten and misunderstood disorder of acid-base balance are discussed.