TY  - JOUR
PY  - 2015//
TI  - High anion gap metabolic acidosis after a suicide attempt with cyanide: the rebirth of cyanide poisoning
JO  - Internal medicine
A1  - Hsiao, Po-Jen
A1  - Chang, Che-Fu
A1  - Chiu, Chih-Chien
A1  - Chan, Jenq-Shyong
A1  - Chiang, Wen-Fang
A1  - Wu, Chia-Chao
A1  - Lin, Shih-Hua
A1  - Chen, Jin-Shuen
SP  - 1901
EP  - 1904
VL  - 54
IS  - 15
N2  - A 33-year-old woman was admitted to our emergency department in a state of unconsciousness after attempting suicide with unknown substances. Severe metabolic acidosis (pH: 6.81), with a high anion gap (36.2) and high lactate level (20.2 mmol/L), was observed. After four hours of intensive medical treatment, the patient regained consciousness, with a return of the arterial pH to 7.42. Finally, cyanide intoxication was diagnosed based on the detection of a serum cyanide level of 3.5 mg/L. The presence of a high anion gap associated with severe lactic acidosis is a clue for making a rapid differential diagnosis of acute cyanide intoxication. Providing intensive and immediate supportive management is also crucial, even in cases without obtainable specific antidotes.<p />  <p>Language: en</p>
LA  - en
SN  - 0918-2918
UR  - http://dx.doi.org/10.2169/internalmedicine.54.4272
ID  - ref1
ER  -