Alcoholic ketoacidosis: a case report and review of the literature.

Alcoholic ketoacidosis (AKA) is a cause of severe metabolic acidosis usually occurring in malnourished patients with a history of recent alcoholic binge, often on a background of alcohol dependency. AKA can be fatal due to associated electrolyte abnormalities and subsequent development of cardiac arrhythmias. This is a diagnosis that is often delayed or missed, in patients who present with a severe lactic and ketoacidosis.

Is an atypical presentation becoming typical of coeliac disease?

A 38-year-old woman was referred to a gastroenterology clinic for investigation of abnormal liver function test (LFT). She had no history of pre-existing liver disease, diabetes mellitus, hypertension, excess alcohol consumption or use of any hepatotoxic drugs. She was being investigated and treated by oral surgeons for recurrent mouth ulcers which she had for about 18 months.

A rare cause of dysphagia and gastroparesis.

An 82-year-old woman was admitted with severe vomiting and progressive dysphagia mainly to solids. She gave a 3-month history of increasing heartburn, vomiting, tiredness, lethargy, anorexia and 13 kg weight loss. Her past medical history was unremarkable and she was a non-smoker.