[Diagnosis in metabolic acidosis of unknown origin].
BACKGROUND
Obtaining a precise diagnosis in patients presenting with metabolic acidosis of unknown origin is difficult. Poisoning with methanol or ethylene glycol should be suspected in cases with a combined increase of osmolal and anion gaps.


METHODS
Retrospectively we have compared the methanol and ethylene glycol values in poisoned patients with their osmolal gaps. The anion gaps are compared to the toxic anions measured.


RESULTS
There were good correlations between serum alcohols and osmolal gaps and between toxic metabolites and anion gaps.


CONCLUSIONS
The osmolal and the anion gaps are both helpful tools in the diagnosis of patients with metabolic acidosis of unknown origin, especially for identifying patients poisoned with methanol or ethylene glycol.
Hovda
Knut Erik
KE
Akuttmedisinsk avdeling, Medisinsk divisjon, Ullevål universitetssykehus, 0407 Oslo. knov@uus.no
Hunderi
Odd Helge
OH
Øvrebø
Steinar
S
Jacobsen
Dag
D
D000138:Acidosis / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D000435:Alcoholic Intoxication / Q000150:complications / Q000175:diagnosis / Q000378:metabolism; D003937:Diagnosis, Differential; D005026:Ethylene Glycols / Q000097:blood / Q000378:metabolism / Q000506:poisoning*; D006801:Humans; D000432:Methanol / Q000097:blood / Q000378:metabolism / Q000506:poisoning*; D009994:Osmolar Concentration; D012016:Reference Values; D012189:Retrospective Studies
D005026:Ethylene Glycols; D000432:Methanol