Acetone anaemia

Acetone anaemia (synonym of ketonemia) - blood levels of acetone (ketone) tel: acetoacetic, beta-hydroxybutyric acid, acetone. Acetone bodies are formed mainly in the liver from fatty acids. In physiological terms, the rate of formation of ketone bodies corresponds to their dissolution, normally their content in the blood is 0.7-0.8 mg % . The increase in the content of ketone bodies in the blood and tissues - ketosis (hyperchloremia, hyperketonemia; sometimes this state incorrectly termed "acetone anaemia") - can come as a result of intensified, but not complete oxidation of fatty acids, which in most cases associated with a decrease in the body's reserves of carbohydrates. Ketosis is accompanied by such diseases as diabetes mellitus, insulin hypoglycemia. To ketosis can also lead hypoxia, poisoning, infections that cause fatty infiltration of the liver, excessive introduction of glucocorticoids when insulin deficiency. Significant accumulation of acetone bodies (60-190 mg%) is observed in diabetic coma.
The toxic effect of hyperketonemia on the body is manifested in the inhibitory influence on the Central nervous system, the pH of blood acidic side, considerable loss of urine potassium and sodium, toxic effect on the kidneys with the development of secondary oliguria and even anurii. Children often hyperketonemia manifests itself as recurrent uncontrollable vomiting - acetonemia vomiting. Its cause may be the failure of the liver, metabolism, and persistent changes in the area of diencephalic. Vomiting often begins unexpectedly, but sometimes with warning signs that appear within 1 to 2 days (weakness, headache, smell of acetone breath). An attack can last 2-3 days and accompanied by severe dehydration, and violation of other types of exchange. Remission last from several weeks to several months.
Treatment of hyperketonemia should be made to improve liver function. This is achieved by restriction of fat in the diet, as well as the appointment of lipotropic substances (methionine - children up to 1 year - 0.2-0.3 g; 2-4 years - 0.4 g; 5-14 years - 0.5 g C-4 times for 30 minutes before meals with syrup, jelly, milk). Simultaneously with methionine give lipokain 0.1 g 2-3 times a day. Effective application of vitamin B12 injection of 10 - 30-50 mcg 2 times a week, and insulin. When acetoneiso vomiting than the specified treatment, shown stomach scene, the introduction of the inside 4% solution of sodium bicarbonate, izotoniceski solution of sodium chloride.

Acetone anaemia (acetonaemia; acetone and Greek. haima, blood; a synonym for ketonemia) - blood levels of acetone (ketone) tel: acetoacetic, beta-hydroxybutyric acid or acetone. Their education is the liver. Acetone anaemia is observed in diabetes, starvation, uncontrollable vomiting during pregnancy, air anaesthesia, intestinal obstruction, insulin hypoglycemia. A significant increase in the number of acetone bodies in the blood found in diabetic coma. Cm. the Acetone Acetone body.
Acetonemia vomiting (synonym: uncontrollable vomiting with acetonemia, cyclical or recurrent, vomiting, recurrent vomiting acetonemia) - repeated vomiting with violation of the General condition, disorder of metabolism, especially carbohydrate and fat, and allocation of acetone in the urine and with exhaled air. Observed in children of preschool age with increased excitability of the nervous system in combination with a tendency to the development of acetonemia because of reduced kataliza.
It is assumed that acetone anaemia and hypoglycemia caused by temporary disturbance of the function of the pancreas and adrenal glands.
The content of glycogen in the liver is reduced; the lack of carbohydrates in food and hypoglycemia promote increase in blood acetone bodies, causing vomiting. The emergence of vomiting is also promoted by the excitement of the child, infectious diseases, and receive ketogenic food high in fat and relatively small amount of carbohydrates.
Acetonemia vomiting occurs suddenly, often in the morning, is repeated until 20 to 50 times a day; this lasts from one to three days (L. Rachev with labour). Developing dehydration and reduces the weight of the body. Breathing deepened and slowed down. There are tachycardia and muted tones of the heart. Often, the pain in the abdomen, caused by spasms of the stomach and intestines. The liver is enlarged.
In extremely rare deaths discover fatty infiltration of the liver and hemorrhage into the internal organs. The temperature is usually normal or low-grade. The content of acetone bodies in the blood exceeds 10 mg%, sugar content is reduced. Expressed leukocytosis, limfopenia and monocytopenia. Marked acetonuria and urobilinemia.
The differential diagnosis spend with secondary vomiting associated with acute gastroenteritis, meningitis, brain tumor, scarlet fever, epidemic hepatitis and appendicitis.
When prekomatosny condition in children with diabetes diabetes (see), also there are a number of symptoms that are similar to acetoneiso vomiting. However, hyperglycemia and carbohydraturia are sufficient for a diagnosis of diabetes. Forecast: as a rule, complete recovery. It rarely coming death can cause a cardiac arrest, respiratory paralysis due to a sharp toxicity, dehydration, and hypokalemia.
Treatment. Bed rest. At the beginning of the disease complete restriction of food. Inside 5-10% glucose solution 1 teaspoon every 20-30 minutes In micro impose on 20 ml of physiological solution mixed with 10% glucose solution. If no effect injected with saline and 5% glucose solution subcutaneously or intravenously. Positive effect and stomach wash saline solution, or 1% solution of baking soda. According to the testimony appoint kordiamin and caffeine. Cm. also Vomiting.