Alcoholic ketoacidiosis: a cause of sudden death of chronic alcoholics

In forensic medicine we often deal with cases of sudden death of chronic al coholics from various aspects; above all we must establish the immediate ca use of death. Most of the time the cause of death becomes clear from autops ies, histological, alcoholimetric and toxicological tests, but in a smaller number of cases it remains indeterminate even after these procedures. In o ur study we attempted to establish whether these cases of sudden death coul d be cases of alcoholic ketoacidosis. We studied 30 cases of sudden death o f chronic alcoholics, for all of which autopsies, histological, alcoholimet ric and toxicological tests had been performed, and for which we determined the beta-hydroxybutyrate concentration in bodily fluid samples (blood, uri ne, cerebrospinal fluid and vitreous humour). In the group with indetermina te cause of death (seven cases) the average measured concentration of beta- hydroxybutyrate in the blood, urine and vitreous humour was at least ten ti mes higher than the concentrations in the group with clear causes of death, while the concentration of beta-hydroxybutyrate in the cerebrospinal fluid did not differ significantly between the two groups. (C) 1999 Elsevier Sci ence Ireland Ltd. All rights reserved.