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Case report
Ketoacidosis associated with ketogenic diet in a non-diabetic lactating woman
  1. Ali Alkhayat1,
  2. Kevin Arao2,
  3. Taro Minami3 and
  4. Kamran Manzoor4
  1. 1Internal Medicine, Kent Hospital, Northborough, Massachusetts, USA
  2. 2Internal Medicine, Kent Hospital, Warwick, Rhode Island, USA
  3. 3Division of Pulmonary, Critical Care and Sleep Medicine, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
  4. 4Division of Pulmonary and Critical Care Medicine, South Shore Hospital, Weymouth, Massachusetts, USA
  1. Correspondence to Dr Ali Alkhayat; ali_alkhayat{at}


A 37-year-old woman who had 8 weeks post partum, breast feeding and on a low carbohydrate and high protein (ketogenic) diet, was admitted to the hospital with acute onset of nausea, vomiting and abdominal pain of 1-day duration. On admission, she was found to have high anion gap metabolic acidosis, elevated beta-hydroxybutyric acid level, normal glucose level and evidence of ketoacidosis. She was treated with lactated Ringer solution, along with dextrose 5% solution with the resolution of symptoms and metabolic derangement.

  • diet
  • nutrition and metabolism

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  • Contributors KM conceived of the presented idea. All authors discussed the case and came with a plan. AA and KA reviewed related cases and current guidelines of the subject of the case. AA and KA wrote the initial manuscript. KM and TM provided critical feedback. KM and TM helped with editing. TM helped revise the resources. AA wrote the final version. All authors discussed and agreed on the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests One of the coauthors (TM) reports personal fees and non-financial support from consultant of FUJIFILM Corp/Japan International Cooperation Agency (JICA), outside the submitted work.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.