@article{ref1,
title="Spurious point-of-care lactate elevation in ethylene glycol intoxication: rediscovering a clinical pearl",
journal="BMJ case reports",
year="2021",
author="Poirier-Blanchette, Laurence and Simard, Camille and Schwartz, Blair Carl",
volume="14",
number="2",
pages="e239936-e239936",
abstract="A 76-year-old man was found unresponsive and brought to the emergency department. Initial workup showed profound lactic acidosis on a point-of-care arterial blood gas, without clinical signs of hypoperfusion. Investigations for types A and B lactic acidosis revealed no unifying diagnosis to explain both his altered mental status and profound lactic acidosis. A toxicology workup revealed an increased osmolar gap and an elevated ethylene glycol level. The lactic acidosis and his mental status completely normalised within 8 hours of renal replacement therapy initiation and fomepizole administration. Ethylene glycol metabolites have similar molecular structure with L-lactate. Some blood gas analysers are unable to differentiate them, resulting in an artefactual lactate elevation. Our case highlights the importance of recognising a falsely elevated lactate, which should raise clinical suspicion of ethylene glycol poisoning, as the treatment is time-sensitive to prevent complications and mortality.<p /> <p>Language: en</p>",
language="en",
issn="1757-790X",
doi="10.1136/bcr-2020-239936",
url="http://dx.doi.org/10.1136/bcr-2020-239936"
}