Metabolic acidosis with extreme elevation of anion gap: Case report and literature review

James R. Oster, Irwin Singer, Gabriel N. Contreras, H. I. Ahmad, Cristovao F. Vieira

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

A patient with severe metabolic acidosis and an extremely elevated (57 mEq/L) serum anion gap (AG) is described, and the multiple factors that produced the patient's complex abnormalities are discussed in detail. These include renal failure, rhabdomyolysis, marked hyperphostemia, hemoconcentration, and an unidentified organic metabolic acidosis. A review of the literature indicates that the common thread observed in almost each instance of profoundly elevated AG values is a multifactorial pathogenesis that usually includes renal insufficiency, associated with a proven or likely cause of organic metabolic acidosis, or with exogenous phosphate intoxication.

Original languageEnglish (US)
Pages (from-to)38-49
Number of pages12
JournalAmerican Journal of the Medical Sciences
Volume317
Issue number1
DOIs
StatePublished - Jan 1999

Keywords

  • Anion gap
  • Hyperphosphatemia
  • Metabolic acidosis
  • Renal failure
  • Rhabdomyolysis

ASJC Scopus subject areas

  • Medicine(all)

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