Cetoacidosis por estrés: caso clínico en paciente con atrofia muscular espinal

Spinal muscular atrophy is an uncommon cause of ketoacidosis, where there is a decrease in muscle mass, an abnormal metabolism of glucose and fatty acids, and changes in neuroendocrine function. These conditions favor the accumulation of keto acids and the development of metabolic acidosis. We repor...

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Autores principales:	Aguilar,Carolina, Sepúlveda,Rodrigo Andrés, Tagle,Rodrigo
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2020
Materias:	Acidosis Ketosis Muscular Atrophy Spinal Oxaloacetates
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000600875
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spelling	oai:scielo:S0034-988720200006008752020-09-29Cetoacidosis por estrés: caso clínico en paciente con atrofia muscular espinalAguilar,CarolinaSepúlveda,Rodrigo AndrésTagle,Rodrigo Acidosis Ketosis Muscular Atrophy Spinal Oxaloacetates Spinal muscular atrophy is an uncommon cause of ketoacidosis, where there is a decrease in muscle mass, an abnormal metabolism of glucose and fatty acids, and changes in neuroendocrine function. These conditions favor the accumulation of keto acids and the development of metabolic acidosis. We report a 26-year-old female, with a history of spinal muscular atrophy type III, consulting for abdominal pain and vomiting lasting one week. She was admitted to the emergency service somnolent and poorly perfused. She had a pH of 6.98, HCO3- of 3.8 mmol/L, pCO2 of 16.4 mmHg, BE of -26 mmol/L, delta ratio of 1.05, anion gap of 31 mEq/L, creatinine of 0.37 mg/dL, sodium of 147 mEq/L, potassium of 3.7 mEq/L, chloride of 112 mEq/L, lactate of 1.2 mmol/L, glucose of 108 mg/dL, albumin of 4.2 g/dL, ketonemia +++, ketonuria +, measured plasma osmolality of 322 mOsm/kg, estimated osmolality of 314 mOsm/kg, toxilab negative, salicylate levels < 3 µg/mL, acetaminophen levels < 1.2 µg/mL. Intravenous hydration and bicarbonate were started, without satisfactory response. Interpreting the clinical picture as a ketoacidosis induced by stress in a patient with spinal muscular atrophy, it was handled with glucose, amino acids, vitamins and trace elements, with a favorable response.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.148 n.6 20202020-06-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000600875es10.4067/S0034-98872020000600875
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Acidosis Ketosis Muscular Atrophy Spinal Oxaloacetates
spellingShingle	Acidosis Ketosis Muscular Atrophy Spinal Oxaloacetates Aguilar,Carolina Sepúlveda,Rodrigo Andrés Tagle,Rodrigo Cetoacidosis por estrés: caso clínico en paciente con atrofia muscular espinal
description	Spinal muscular atrophy is an uncommon cause of ketoacidosis, where there is a decrease in muscle mass, an abnormal metabolism of glucose and fatty acids, and changes in neuroendocrine function. These conditions favor the accumulation of keto acids and the development of metabolic acidosis. We report a 26-year-old female, with a history of spinal muscular atrophy type III, consulting for abdominal pain and vomiting lasting one week. She was admitted to the emergency service somnolent and poorly perfused. She had a pH of 6.98, HCO3- of 3.8 mmol/L, pCO2 of 16.4 mmHg, BE of -26 mmol/L, delta ratio of 1.05, anion gap of 31 mEq/L, creatinine of 0.37 mg/dL, sodium of 147 mEq/L, potassium of 3.7 mEq/L, chloride of 112 mEq/L, lactate of 1.2 mmol/L, glucose of 108 mg/dL, albumin of 4.2 g/dL, ketonemia +++, ketonuria +, measured plasma osmolality of 322 mOsm/kg, estimated osmolality of 314 mOsm/kg, toxilab negative, salicylate levels < 3 µg/mL, acetaminophen levels < 1.2 µg/mL. Intravenous hydration and bicarbonate were started, without satisfactory response. Interpreting the clinical picture as a ketoacidosis induced by stress in a patient with spinal muscular atrophy, it was handled with glucose, amino acids, vitamins and trace elements, with a favorable response.
author	Aguilar,Carolina Sepúlveda,Rodrigo Andrés Tagle,Rodrigo
author_facet	Aguilar,Carolina Sepúlveda,Rodrigo Andrés Tagle,Rodrigo
author_sort	Aguilar,Carolina
title	Cetoacidosis por estrés: caso clínico en paciente con atrofia muscular espinal
title_short	Cetoacidosis por estrés: caso clínico en paciente con atrofia muscular espinal
title_full	Cetoacidosis por estrés: caso clínico en paciente con atrofia muscular espinal
title_fullStr	Cetoacidosis por estrés: caso clínico en paciente con atrofia muscular espinal
title_full_unstemmed	Cetoacidosis por estrés: caso clínico en paciente con atrofia muscular espinal
title_sort	cetoacidosis por estrés: caso clínico en paciente con atrofia muscular espinal
publisher	Sociedad Médica de Santiago
publishDate	2020
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000600875
work_keys_str_mv	AT aguilarcarolina cetoacidosisporestrescasoclinicoenpacienteconatrofiamuscularespinal AT sepulvedarodrigoandres cetoacidosisporestrescasoclinicoenpacienteconatrofiamuscularespinal AT taglerodrigo cetoacidosisporestrescasoclinicoenpacienteconatrofiamuscularespinal
_version_	1718437136292642816

Cetoacidosis por estrés: caso clínico en paciente con atrofia muscular espinal

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