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A Diabetic Ketoacidosis Mimic

Richard J. Foley, MD

JAMA. 1985;254(8):1066-1067.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

DIABETIC ketoacidosis is a relatively simple diagnosis in a patient known to have diabetes, yet the differential diagnosis on the initial presentation of a new patient includes all the standard causes of an elevated anion gap acidosis.¹ In a patient with severe anion gap acidosis, hyperglycemia, and ketonuria, the presumptive diagnosis would be diabetic ketoacidosis. Because ketones can elevate serum creatinine levels through chemical interference, an inappropriately elevated serum creatinine level provides indirect evidence for ketosis.² The following case report describes a patient with marked anion gap acidosis, hyperglycemia, glycosuria, elevated creatinine levels, and ketonuria who did not have diabetic ketoacidosis or diabetes mellitus.

Report of a Case

A 28-year-old man was brought to the emergency room after being found "down" at his work site 15 minutes after the start of his shift. He was conscious on arrival (30 minutes after being found) and complained of severe chest . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Medicine, University of Texas Health Science Center—Houston, and the Acute Dialysis Unit, Houston Northwest Medical Center Hospital.

Footnotes
Reprint requests to 800 Peakwood, Suite 6D, Houston, TX 77090 (Dr Foley).

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