title: Recurrent severe anion gap metabolic acidosis secondary to episodic ethylene glycol intoxication.
abstract: Acute ethylene glycol toxicity and its attendant metabolic derangement is a well described clinical entity. Recurrent severe anion gap metabolic acidosis consequent to episodic ingestion of ethylene glycol has not been previously reported. We present a patient who developed severe anion gap metabolic acidosis with no osmolar gap and hypokalemia, consequent to episodic ethylene glycol ingestion. Modest artifactual elevation of the serum lactic acid level and rapid response to intravenous bicarbonate infusion may serve as diagnostic clues. Consideration of these aberrant features should be included in the clinical assessment of severe anion gap metabolic acidosis.
authors.affiliation: Division of Nephrology, Department of Medicine, School of Medicine, State University of New York at Stony Brook, Stony Brook, NY 11794, USA.
authors.forename: S
authors.initials: S
authors.lastname: Moossavi
authors.forename: N K
authors.initials: NK
authors.lastname: Wadhwa
authors.forename: E P
authors.initials: EP
authors.lastname: Nord
mesh_terms: D000136:Acid-Base Equilibrium; D000138:Acidosis / Q000139:chemically induced* / Q000378:metabolism; D000328:Adult; D019855:Ethylene Glycol / Q000506:poisoning*; D005260:Female; D006801:Humans; D012008:Recurrence
chemical_list: D019855:Ethylene Glycol