Lactate gap as a tool in identifying ethylene glycol poisoning

BMJ Case Rep. 2018 Mar 9:2018:bcr2018224243. doi: 10.1136/bcr-2018-224243.

Abstract

Ethylene glycol toxicity is a known cause of anion gap metabolic acidosis, with the presence of an osmolar gap and the right clinical context suggesting to the diagnosis. Rapid recognition and early treatment is crucial. Unfortunately, ethylene glycol levels are not readily available and must be performed at a reference laboratory. We present a case where recognising the significance of the 'lactate gap' assisted in identifying ethylene glycol poisoning.

Keywords: adult intensive care; poisoning.

Publication types

  • Case Reports

MeSH terms

  • Acidosis / chemically induced*
  • Acidosis / complications
  • Acidosis / therapy
  • Antidotes / therapeutic use
  • Diagnosis, Differential
  • Dialysis / methods
  • Ethylene Glycol / poisoning*
  • Fomepizole
  • Humans
  • Lactic Acid / blood*
  • Male
  • Middle Aged
  • Pyrazoles / administration & dosage
  • Pyrazoles / therapeutic use*
  • Treatment Outcome

Substances

  • Antidotes
  • Pyrazoles
  • Lactic Acid
  • Fomepizole
  • Ethylene Glycol