Rapid diagnosis of alcoholic ketoacidosis by proton NMR

In alcoholic patients, metabolic acidosis can be related to lactate acidosi s associated with sepsis or thiamine deficiency ketoacidosis, methanol or e thylene glycol poisoning. High resolution proton nuclear magnetic resonance (NMR) can be used to detect abnormal organic acid metabolites in urine or serum from patients with various metabolic disorders. In the present case, a 26-year-old patient was admitted for a coma associated with severe metabo lic acidosis. Alcoholic ketoacidosis (AKA) was identified by urine proton N MR, Her metabolic disorders rapidly improved. Persisting associated neurolo gical alteration was related to extrapontine myelinolysis as shown by imagi ng cerebral NMR.