title: Metabolic acidosis during treatment of mushroom poisoning: a diagnostic pitfall.
abstract: Metabolic acidosis is a frequently encountered acid-base disturbance in hospitalized patients that occasionally develops in the course of treatment with medications used in everyday clinical practice, including propylene glycol-containing drugs (lorazepam, diazepam, etomidate, pentobarbital). Disruption of enterohepatic circulation with activated charcoal is a common practice for several intoxications, including mushroom poisoning. Herein, we present a patient who was hospitalized due to mushroom intoxication and developed severe metabolic acidosis as a treatment side effect rather than from the mushroom poisoning. To the best of our knowledge, this is the first report on propylene glycol-containing activated charcoal-induced metabolic acidosis.
authors.affiliation: Department of Medicine and Research Lab of Internal Medicine, Thessaly University Medical School, Greece. ngatsel@med.uth.gr
authors.forename: Nikolaos K
authors.initials: NK
authors.lastname: Gatselis
authors.forename: George
authors.initials: G
authors.lastname: Liamis
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Makaritsis
authors.forename: George N
authors.initials: GN
authors.lastname: Dalekos
mesh_terms: D000138:Acidosis / Q000139:chemically induced* / Q000175:diagnosis*; D000368:Aged; D002606:Charcoal / Q000009:adverse effects; D005260:Female; D006801:Humans; D009145:Mushroom Poisoning / Q000175:diagnosis* / Q000188:drug therapy*; D000077385:Silybin; D012838:Silymarin / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D012838:Silymarin; D002606:Charcoal; D000077385:Silybin