• Jiaojiao Liu, Xiangshan Li, Jiali Wu, Yazhuo Chen, Heng Li, and Zhufang Tian.
• Department of Endocrinology, Xi'an Central Hospital, Xi'an, Shaanxi 710003, China; Department of Graduate School, Yan'an University, Yan'an, Shaanxi 716000, China.
• Am J Emerg Med. 2022 Feb 1; 52: 270.e5-270.e8.

AbstractAlcoholic ketoacidosis (AKA) lacks specific clinical presentation. The results of blood testing commonly show hemoconcentration, elevated β-hydroxybutyrate levels, and acidosis in patients with AKA. Herein, we report a case of AKA accompanied by hyperglycemia and review the related literature. Case report: AKA associated with hyperglycemia is rare, and its pathogenesis is similar to that of diabetic ketoacidosis, thereby making differentiation challenging. Accordingly, AKA is easily misdiagnosed by endocrinologists. The main symptoms of a 37-year-old female included hyperglycemia, elevated β-hydroxybutyrate levels, and metabolic acidosis. Primary clinical presentations were severe nausea and vomiting. The patient initially diagnosed with DKA were eventually confirmed as AKA, who recovered after active therapy with rehydration and correction of hyperglycemia, electrolyte imbalance, and ketosis. This study provides a reference for clinicians to reduce missed diagnosis and the misdiagnosis rates of AKA.Copyright © 2021 Elsevier Inc. All rights reserved.

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