Correct!
5. Starvation ketosis

The patient reported that she was adherent to a restricted keto diet while she was breast-feeding her 8 weeks baby. A diagnosis of high anion gap metabolic acidosis due to keto diet on lactation was made. She was admitted to the ICU and she was restarted on an oral carbohydrate diet, a bicarbonate drip and IV fluids. Her anion gap and beta hydroxybutyrate normalized and she was discharged on after 3 days of hospitalization. Prior to discharge, the patient was educated that a keto diet is contraindicated during lactation.

References

1. Gupta L, Khandelwal D, Kalra S, Gupta P, Dutta D, Aggarwal S. Ketogenic diet in endocrine disorders: Current perspectives. J Postgrad Med. 2017 Oct-Dec;63(4):242-251. [CrossRef] [PubMed]
2. Szulewski A, Howes D, Morton AR. A severe case of iatrogenic lactation ketoacidosis. BMJ Case Rep. 2012 Mar 8;2012:bcr1220115409. [CrossRef] [PubMed]
3. Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr. 2013 Aug;67(8):789-96. [CrossRef] [PubMed]
4. Mohammad MA, Sunehag AL, Chacko SK, Pontius AS, Maningat PD, Haymond MW. Mechanisms to conserve glucose in lactating women during a 42-h fast. Am J Physiol Endocrinol Metab. 2009 Oct;297(4):E879-88. [CrossRef] [PubMed]

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