From the Research
Alcoholic ketoacidosis (AKA) is characterized by several key laboratory findings, including a high anion gap metabolic acidosis, elevated ketone bodies, particularly beta-hydroxybutyrate, and electrolyte abnormalities, as noted in the most recent study [ 1 ]. The laboratory findings of AKA typically include:
- A high anion gap metabolic acidosis with a pH usually below 7.3 and bicarbonate levels less than 15 mEq/L
- Blood glucose levels that are generally normal or only mildly elevated, often between 70-250 mg/dL
- Ketone bodies, particularly beta-hydroxybutyrate, that are markedly elevated in both blood and urine
- An anion gap that is typically increased to greater than 15 mEq/L
- Electrolyte abnormalities, including hypokalemia, hypomagnesemia, hypophosphatemia, and hypocalcemia due to poor nutritional intake and vomiting
- Liver function tests that often show elevated transaminases and gamma-glutamyl transferase (GGT) reflecting underlying alcoholic liver disease
- Blood alcohol levels that may be low or undetectable as AKA typically develops during alcohol withdrawal after a binge
- Lactic acidosis that may coexist due to thiamine deficiency and impaired carbohydrate metabolism
- Complete blood count that might reveal macrocytic anemia from folate deficiency or direct toxic effects of alcohol on bone marrow
- Serum osmolal gap that may be elevated if alcohol is still present in the bloodstream, as discussed in [ 1 ]. It is essential to consider these laboratory findings in the diagnosis and management of AKA, as they can help guide treatment and improve patient outcomes, as noted in [ 2 ].