[Clinical, biological and developmental aspects of alcoholic ketoacidosis]

To review cases of alcoholic ketoacidosis in order to better ascertain therapeutic management.The medical files of 32 alcoholic patients with ketoacidosis hospitalized in the Saint-Pierre general hospital of the Reunion island from January 1, 1991 through 31 August 1994 were analyzed.There were 18 women and 14 men, mean age 47 years. The first clinical signs were predominated by digestive (n = 22) or neurological disorders (n = 10). Acidosis was severe (mean pH = 7.12) and always associated with a wide anion gap (mean anion gap = 35). There were 3 types of glycemic status: hypoglycemia 10 cases, normal or subnormal glycemia in 19 cases (mean glycemia = 9.3 mmol/l) and hyperglycemia above 20 mmol/l in 3 cases. Hypophosphatemia, elevated serum lactate levels and cytolytic hepatitis were the main abnormalities associated.Short-term outcome was favorable in all cases after rehydration. The use of insulin may be dangerous and needs to be avoided.