Lactate Gap: A Diagnostic Support in Severe Metabolic Acidosis of Unknown Origin
Ethylene glycol poisoning is a medical emergency. The metabolites glycolate and glyoxylate give metabolic acidosis. Because of similar structure, these metabolites are misinterpreted as lactate by many point-of-care blood gas analyzers. The falsely high lactate values can lead to misdiagnosis, inapp...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2018/5238240 |
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| _version_ | 1832564617309585408 |
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| author | Linn E. Hauvik Mercy Varghese Erik W. Nielsen |
| author_facet | Linn E. Hauvik Mercy Varghese Erik W. Nielsen |
| author_sort | Linn E. Hauvik |
| collection | DOAJ |
| description | Ethylene glycol poisoning is a medical emergency. The metabolites glycolate and glyoxylate give metabolic acidosis. Because of similar structure, these metabolites are misinterpreted as lactate by many point-of-care blood gas analyzers. The falsely high lactate values can lead to misdiagnosis, inappropriate laparotomies, and delayed antidotal therapy. As laboratory analyzers measure plasma lactate only, the difference or the “lactate gap” aids in early diagnosis. We present a patient with severe metabolic acidosis and elevated lactate levels on the point-of-care analyzer. A lactate gap supported the diagnosis of ethylene glycol poisoning. Hemodialysis and fomepizole treatment could be started immediately. |
| format | Article |
| id | doaj-art-7db659969e594d1ca638f51064f1c7c4 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-7db659969e594d1ca638f51064f1c7c42025-02-03T01:10:32ZengWileyCase Reports in Medicine1687-96271687-96352018-01-01201810.1155/2018/52382405238240Lactate Gap: A Diagnostic Support in Severe Metabolic Acidosis of Unknown OriginLinn E. Hauvik0Mercy Varghese1Erik W. Nielsen2Department of Anesthesiology and Critical Care Medicine, Nordland Hospital Bodø, Bodø, NorwayDepartment of Gastrointestinal Surgery, Nordland Hospital Bodø, Bodø, NorwayDepartment of Anesthesiology and Critical Care Medicine, Nordland Hospital Bodø, Bodø, NorwayEthylene glycol poisoning is a medical emergency. The metabolites glycolate and glyoxylate give metabolic acidosis. Because of similar structure, these metabolites are misinterpreted as lactate by many point-of-care blood gas analyzers. The falsely high lactate values can lead to misdiagnosis, inappropriate laparotomies, and delayed antidotal therapy. As laboratory analyzers measure plasma lactate only, the difference or the “lactate gap” aids in early diagnosis. We present a patient with severe metabolic acidosis and elevated lactate levels on the point-of-care analyzer. A lactate gap supported the diagnosis of ethylene glycol poisoning. Hemodialysis and fomepizole treatment could be started immediately.http://dx.doi.org/10.1155/2018/5238240 |
| spellingShingle | Linn E. Hauvik Mercy Varghese Erik W. Nielsen Lactate Gap: A Diagnostic Support in Severe Metabolic Acidosis of Unknown Origin Case Reports in Medicine |
| title | Lactate Gap: A Diagnostic Support in Severe Metabolic Acidosis of Unknown Origin |
| title_full | Lactate Gap: A Diagnostic Support in Severe Metabolic Acidosis of Unknown Origin |
| title_fullStr | Lactate Gap: A Diagnostic Support in Severe Metabolic Acidosis of Unknown Origin |
| title_full_unstemmed | Lactate Gap: A Diagnostic Support in Severe Metabolic Acidosis of Unknown Origin |
| title_short | Lactate Gap: A Diagnostic Support in Severe Metabolic Acidosis of Unknown Origin |
| title_sort | lactate gap a diagnostic support in severe metabolic acidosis of unknown origin |
| url | http://dx.doi.org/10.1155/2018/5238240 |
| work_keys_str_mv | AT linnehauvik lactategapadiagnosticsupportinseveremetabolicacidosisofunknownorigin AT mercyvarghese lactategapadiagnosticsupportinseveremetabolicacidosisofunknownorigin AT erikwnielsen lactategapadiagnosticsupportinseveremetabolicacidosisofunknownorigin |