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

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 hyperphosphatemia, hemoconcent...

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Bibliographic Details
Published inThe American journal of the medical sciences Vol. 317; no. 1; p. 38
Main Authors Oster, J R, Singer, I, Contreras, G N, Ahmad, H I, Vieira, C F
Format Journal Article
LanguageEnglish
Published United States 01.01.1999
Subjects
Acid-Base Equilibrium
Acidosis, Renal Tubular - blood
Acidosis, Renal Tubular - etiology
Acute Kidney Injury - complications
Humans
Male
Middle Aged
Phosphates - blood
Rhabdomyolysis - complications
Uric Acid - blood
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Summary: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 hyperphosphatemia, 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.
ISSN:0002-9629
DOI:10.1016/S0002-9629(15)40468-9