Falsely elevated osmol gap due to hypertonic hyponatremia.
Presence of an elevated osmol gap is frequently used as indirect evidence of toxic alcohol poisoning. We present two cases of suspected toxic alcohol ingestion originating from erroneously calculated osmol gaps secondary to hyperglycemic hyponatremia. Emergency department and poison center staff should be aware of the effect of hyperglycemia on serum sodium, and compensate appropriately when calculating serum osmolarity.
Sztajnkrycer
Matthew D
MD
Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Scaglione
Jan M
JM
D000328:Adult; D002675:Child, Preschool; D003951:Diagnostic Errors; D000431:Ethanol / Q000506:poisoning*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D007010:Hyponatremia / Q000150:complications* / Q000378:metabolism*; D008297:Male; D009994:Osmolar Concentration; D011041:Poisoning / Q000175:diagnosis
D000431:Ethanol