Abstract
We describe a rare case of alcoholic ketoacidosis (AKA) with pancytopenia. A 67-year-old man with consciousness disturbance at home showed shock, hypothermia, and disturbance of consciousness on arrival at our emergency department. He had a history of rarely eating, and drank alcohol in excess. Blood tests revealed hypoglycemia and significant metabolic acidosis. AKA was thus suspected. With transfusion and glucose, his symptoms subsided. Pancytopenia developed on day 2. Bone marrow biopsy on day 5 revealed significant hypoplasia but no neoplastic changes. Serum copper and zinc levels on arrival were normal, but decreased significantly from day 2. The pancytopenia was attributed to malnutrition or deficiencies of microelement nutrients. We administered supplements including microelements. The pancytopenia showed amelioration. Myelogenesis was seen on bone marrow biopsy on day 57. He was transferred to another hospital on day 70. Pancytopenia reportedly occurs with generalized malnutrition, as well as copper and zinc deficiencies. AKA patients are more likely to be malnourished and have microelement deficiencies. Pancytopenia requires attention as an AKA complication.
