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It is clear, e.g., that mild metabolic acidosis, hypoglycemia, and ketosis are consistent with CVS while severe acidosis or hypoglycemia (in particular non-ketotic hypoglycemia) warrant further evaluation for an inborn error of metabolism, especially in infants and toddlers

15 In a similar case, a 24-year-old male without a history of diabetes or excessive alcohol use presented to the ED with shortness of breath, tachypnea, and sinus tachycardia after 3 days of fasting caused by nausea and vomiting