Clinical features

• Excess fat metabolism to fatty acids with ketone production

• An osmotic diuresis with large losses of fluid (up to 6-10l), sodium (400-800 mmol), potassium (250-800 mmol) and magnesium

Symptoms result from hypovolaemia, metabolic acidosis and electrolyte imbalance with polyuria. Hyperventilation is a prominent feature.

Coma need not necessarily be present for life to be threatened.

Plasma amylase commonly exceeds 1000U/l but does not indicate pancreatitis. If suspected, perform an abdominal ultrasound.

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