Nondiabetic Ketoacidosis Caused by Severe Hyperthyroidism

Emily T. Wood; William B. Kinlaw


Thyroid. 2004;14(8) 

In This Article

Abstract and Introduction

Severe hyperthyroidism is not included in the traditional differential diagnosis of ketoacidosis. However, thyroid hormone has well-documented lipolytic effects on adipocytes and may also promote hepatic beta-oxidation. We present a case in which a woman with severe hyperthyroidism developed otherwise unexplained ketoacidosis during the acute phase of her illness. We propose that thyrotoxicosis was a significant contributor to ketoacidosis in this patient and that severe hyperthyroidism should be added to the differential diagnosis of ketoacidosis.

The differential diagnosis of ketoacidosis includes diabetic and alcoholic ketoacidosis, starvation ketosis, lactic and uremic acidosis, severe renal glycosuria, toxic ingestion and rare genetic disorders of ketone metabolism.[1,2] Here we present a case of ketoacidosis in the setting of severe hyperthyroidism. Based on our analysis of the case, we propose that severe hyperthyroidism should be included in the differential diagnosis of ketoacidosis.


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