Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · May 1988
Case Reports[Alcoholic ketoacidosis. An important differential diagnosis from diabetic ketoacidosis].
Ketoacidosis developed in two patients, a woman aged 36 and a man aged 55 years, 48 and 36 hours, respectively, after a bout of drinking alcohol to excess. Both were dehydrated with hyperventilation and signs of cachexia. ⋯ Treatment with insulin and fluids, as well as normalization of the electrolytes, brought about rapid regression of the metabolic disorder and restoration of the carbohydrate metabolism. Both patients were discharged without medication or dietary prescription, other than abstinence from alcohol.
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Obstruction of the oesophagus by a piece of goulash meat resulted in tracheal stenosis in an 18-year-old girl. Because of the history of the illness and information supplied by others, as well as the marked stridor, it was first thought that the tracheal stenosis was at the level of a previous tracheostomy with aspiration, but bronchoscopy revealed marked bulging of the posterior wall of the trachea. Subsequent oesophagoscopy then detected the foreign body, which was removed whole.
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Dtsch. Med. Wochenschr. · Jan 1988
Case Reports[Hemolytic anemia caused by echinocytosis in liver cirrhosis].
Severe haemolytic anaemia developed in a 34-year-old patient with histologically proven alcoholic liver cirrhosis. While in the blood smear there were only a few acanthocytes, under light-microscopy of EDTA-blood 70% of erythrocytes in the counting chamber were acanthocytes or echinocytes, a finding confirmed under the electromicroscope. It is likely that the echinocytosis and acanthocytosis were the cause of the haemolytic anaemia. Biochemical investigation of the lipid composition of the erythrocyte membrane and of plasma and of the apolipoproteins in plasma revealed a series of changes whose role in haemolysis is discussed.