Citation

Gaddam M, Velagapudi RK, Abu Sitta E, Kanzy A. BMJ Case Rep. 2017; 2017(ePub): ePub.

Affiliation

Department of Internal Medicine, Hurley Medical Center, Flint, Michigan, USA.

Copyright

(Copyright © 2017, BMJ Publishing Group)

DOI

10.1136/bcr-2017-221739

PMID

29038192

Abstract

A 60-year-old African-American man with a medical history significant for heavy alcohol abuse, hypertension, delirium tremens, nephrolithiasis and seizure disorder was brought to the hospital with altered mental status. He was found to have high anion gap metabolic acidosis with significantly elevated lactate along with an elevated osmolal gap and calcium oxalate crystals in his urine. With this combination of findings, ethylene glycol poisoning was high in the differential. This case report describes why ethylene glycol poisoning was not the diagnosis in this patient despite the presence of these three classic laboratory findings, therefore emphasising the fact that these findings should not be taken at face value because they can be seen collectively in a patient yet each have a different cause.

© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Language: en

Keywords

adult intensive care; alcohol-related disorders; poisoning