title: Spurious Hyperchloremia and Negative Anion Gap in a Child with Refractory Epilepsy.
abstract: We report a case with spurious hyperchloremia with negative anion gap in a child who was taking potassium bromide for refractory epilepsy. Blood chemistry showed a high chloride level (171 mEq/L) and a negative anion gap (-52 mEq/L). Plasma chloride concentration is measured by an ion-selective electrode method; however the presence of other anions like bromide and iodides can interfere with chloride level and largely overestimates the chloride concentration. Thus hyperchloremia with a negative anion gap is a clue to the diagnosis of halides like bromide and iodide ingestion.
authors.affiliation: Division of Critical Care Medicine and Nemours Children's Hospital, Orlando, FL 32827, USA; University of Central Florida College of Medicine, Orlando, FL 32827, USA.
authors.forename: Madhuradhar
authors.initials: M
authors.lastname: Chegondi
authors.affiliation: Division of Critical Care Medicine and Nicklaus Children's Hospital, Miami, FL 33155, USA; Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA.
authors.forename: Balagangadhar R
authors.initials: BR
authors.lastname: Totapally