title: [Factitious hyperchloremia disclosing bromide poisoning. 4 cases].
abstract: BACKGROUND
  When routine blood chemistry shows elevated chloride alone, another anion (bromide, iodine, fluoride) may be involved.
  
  
  METHODS
  Hyperchloremia and decreased anion gap was observed in four patients. Chloremia ranged from 134 to 174 mmol/l at initial blood tests. Careful history taking led to the discovery of long-term use of calcium bromogalacto-glucomate. Specific assay with inductively coupled plasma mass spectrometry (ICPMS) confirmed the presence of bromide in the blood. Chloridemia returned to normal levels after discontinuing use of bromine.
  
  
  CONCLUSIONS
  Bromism is not a common diagnosis. Risks include neurological and psychiatric disorders due to bromide diffusion through the blood-brain barrier. Clinical manifestations have been described including skin lesions, digestive intolerance, and fever. Bromide is contained in certain prescription drugs. Patients should be warned against the adverse effects of overuse.
authors.affiliation: Service de Médecine 1, Néphrologie et Endocrinologie, Chu, Dijon.
authors.forename: B
authors.initials: B
authors.lastname: Bonnotte
authors.forename: C
authors.initials: C
authors.lastname: Jolimoy
authors.forename: A
authors.initials: A
authors.lastname: Pacaud
authors.forename: Y
authors.initials: Y
authors.lastname: Belleville
authors.forename: P
authors.initials: P
authors.lastname: Allain
authors.forename: D
authors.initials: D
authors.lastname: Chevet
mesh_terms: D000328:Adult; D000368:Aged; D001965:Bromides / Q000097:blood / Q000506:poisoning*; D002712:Chlorides / Q000097:blood*; D005260:Female; D006801:Humans; D008875:Middle Aged
chemical_list: D001965:Bromides; D002712:Chlorides