title: Late Metabolic Acidosis Caused by Renal Tubular Acidosis in Acute Salicylate Poisoning.
abstract: A 16-year-old man was transferred to our emergency department seven hours after ingesting 486 aspirin tablets. His blood salicylate level was 83.7 mg/dL. He was treated with fluid resuscitation and sodium bicarbonate infusion, and his condition gradually improved, with a decline in the blood salicylate level. However, eight days after admission, he again reported nausea, a venous blood gas revealed metabolic acidosis with a normal anion gap. The blood salicylate level was undetectable, and a urinalysis showed glycosuria, proteinuria and elevated beta-2 microglobulin and n-acetyl glucosamine levels, with a normal urinary pH despite the acidosis. We diagnosed him with relapse of metabolic acidosis caused by renal tubular acidosis.
authors.affiliation: The Department of Emergency and Critical Care Medicine, Niigata City General Hospital, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Sakai
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hirose
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Sato
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kondo
authors.forename: Yuko
authors.initials: Y
authors.lastname: Shimada
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Hori
mesh_terms: D000136:Acid-Base Equilibrium; D000138:Acidosis / Q000209:etiology*; D000141:Acidosis, Renal Tubular / Q000139:chemically induced / Q000150:complications; D000293:Adolescent; D001241:Aspirin / Q000633:toxicity*; D005440:Fluid Therapy; D006801:Humans; D008297:Male; D017693:Sodium Bicarbonate / Q000627:therapeutic use; D016482:Urinalysis
chemical_list: D017693:Sodium Bicarbonate; D001241:Aspirin