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18 Possible Causes for Anion Gap Increased, Fasting Ketosis

  • Diabetic Ketotic Coma

    Laboratory evaluation reveals hyperglycemia, ketosis (β-hydroxybutyrate acetoacetate), and metabolic acidosis (arterial pH 6.8–7.3) with an increased anion gap ( Table 24-[accessmedicine.mhmedical.com] Ketosis is most commonly caused by very low carbohydrate consumption or prolonged fasting.[docsopinion.com] […] in free calcium since the excess hydrogen displaces calcium from albumin Serum bicarbonate 15mEq/L Moderate ketonuria and ketonemia Labs show: increased anion gap metabolic[medbullets.com]

  • Alcoholic Ketoacidosis

    A high osmolal gap associated with increased anion gap acidosis is said to be indicative of toxic alcohol poisoning though this is not at all specific [Salem and Mujais 1992[ncbi.nlm.nih.gov] Some medical professionals confuse ketoacidosis, an extremely abnormal form of ketosis, with the normal benign ketosis associated with ketogenic diets and fasting states in[ketogenic-diet-resource.com] Metabolic acidosis with an increased anion gap, decreased PaCO2 and ketonemia were present.[ncbi.nlm.nih.gov]

  • Salicylate Poisoning

    gap.[ncbi.nlm.nih.gov] Ketoacidosis may also occur in children who are ill and fasted (ie starvation ketosis).[anaesthesiamcq.com] Uncoupling of the mitochondrial oxidative phosphorylation results in accumulation of organic acid which results in increased anion gap acidosis.[jpma.org.pk]

  • Diabetic Ketoacidosis

    Abstract Diabetic ketoacidosis is characterized by hyperglycemia, anion-gap acidosis, and increased plasma ketones.[ncbi.nlm.nih.gov] Ketosis can happen if you have not eaten for several days or more (called fasting ketosis or starvation ketosis) or if you have prolonged, uncontrollable vomiting (for example[mydr.com.au] The anion gap will increase when the concentration of plasma K , Ca 2 , or Mg 2 is decreased, when organic ions such as lactate are increased (or foreign anions accumulate[themedicalbiochemistrypage.org]

  • Disorder of Fructose Metabolism

    Presence of severe metabolic acidosis with increased anion gap should arouse suspicion of an IEM.[patient.info] Deficiency of fructose-1,6-biphosphatase This deficiency compromises gluconeogenesis and results in fasting hypoglycemia, ketosis, and metabolic acidosis .[merckmanuals.com] […] and/or conduction blocks Post-prandial hyperglycemia Lactic acidosis Hepatomegaly (with hepatic adenomas ) Severe fasting hypoglycemia , mild ketosis Severe hyperlipidemia[amboss.com]

  • Glycogen Storage Disease due to Glucose-6-Phosphat Transport Defect

    Uric acid, ketoacids, and free fatty acids further increase the anion gap .[en.wikipedia.org] Therefore, there is often ketosis after a routine overnight fast.[tp.amegroups.com] , or lactic acidosis; episodes provoked by fasting, febrile infection, or ingestion of fructose, sorbitol, or glycerol Treatment: Avoidance of fasting and fructose, sorbitol[msdmanuals.com]

  • Disorder of Carbohydrate Metabolism

    Presence of severe metabolic acidosis with increased anion gap should arouse suspicion of an IEM.[patient.info] […] and/or conduction blocks Post-prandial hyperglycemia Lactic acidosis Hepatomegaly (with hepatic adenomas ) Severe fasting hypoglycemia , mild ketosis Severe hyperlipidemia[amboss.com] Hypoglycemia, lactic acidosis, hyperlipidemia and ketosis during prolonged fasting periods. Infancy or childhood onset, symptoms tend to improve with age.[en.wikipedia.org]

  • Medium Chain Acyl CoA Dehydrogenase Deficiency

    They may have elevated liver enzymes, acidosis with increased anion gap, hyperuricemia, and hyperammonemia.[invitae.com] Clinical studies revealed an absence of ketosis on fasting (plasma beta-hydroxybutyrate less than 0.4 mmole/liter) despite elevated levels of free fatty acids (2.6-4.2 mmole[ncbi.nlm.nih.gov] Typically hypoketotic hypoglycemia, lethargy and vomiting are triggered by an infection, fasting or surgery.[orpha.net]

  • Gluconeogenesis Disorder

    Uric acid, ketoacids, and free fatty acids further increase the anion gap .[en.wikipedia.org] , or lactic acidosis; episodes provoked by fasting, febrile infection, or ingestion of fructose, sorbitol, or glycerol Treatment: Avoidance of fasting and fructose, sorbitol[msdmanuals.com] The disorder is manifested by the appearance of hypoglycaemia, ketosis and lactic acidosis (neonatally or later during fasting or induced by fructose) and may also be life-threatening[casereports.bmj.com]

  • Pyroglutamate Hydrolase Deficiency

    Gap is Unreliable Urine Anion Gap is Not Reliable in Neonates : neonates excrete other unmeasured anions at relatively high rates Diabetic Ketoacidosis : due to increased[mdnxs.com] As even DCA; from plastic containers; uremiaPeroxisomal diseases Unsaturated DCA ( 59 )KetosisVLCAD deficiency; CPT II deficiency 3-Hydroxy DCA ( 60 )MCT administration; fasting[clinchem.aaccjnls.org] […] to increased urinary excretion of unmeasured non-chloride anion, 5-oxoproline Urine Osmolal Gap Rationale : urine osmolal gap performs better as a surrogate of the urine[mdnxs.com]

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