title: [Diagnosis in metabolic acidosis of unknown origin].
abstract: 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.
authors.affiliation: Akuttmedisinsk avdeling, Medisinsk divisjon, Ullevål universitetssykehus, 0407 Oslo. knov@uus.no
authors.forename: Knut Erik
authors.initials: KE
authors.lastname: Hovda
authors.forename: Odd Helge
authors.initials: OH
authors.lastname: Hunderi
authors.forename: Steinar
authors.initials: S
authors.lastname: Øvrebø
authors.forename: Dag
authors.initials: D
authors.lastname: Jacobsen
mesh_terms: 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
chemical_list: D005026:Ethylene Glycols; D000432:Methanol