Jurnal Internasional Afrika vol. 10 issue 1 2020
African Journal of Emergency Medicine
High-anion gap hyperchloremic acidosis mimicking diabetic ketoacidosis on initial presentation – Case report
Dublin Core
Title
Jurnal Internasional Afrika vol. 10 issue 1 2020
African Journal of Emergency Medicine
High-anion gap hyperchloremic acidosis mimicking diabetic ketoacidosis on initial presentation – Case report
African Journal of Emergency Medicine
High-anion gap hyperchloremic acidosis mimicking diabetic ketoacidosis on initial presentation – Case report
Subject
Diabetic ketoacidosis
Hyperchloremia
Non-anion gap metabolic acidosis
High-anion gap metabolic acidosis
Hyperchloremia
Non-anion gap metabolic acidosis
High-anion gap metabolic acidosis
Description
Introduction: Diabetic ketoacidosis (DKA) often becomes the primary focus and in turn masks a similar serious
condition like hyperchloremic metabolic acidosis.
Case report: A 20 years old female with type 1 diabetes mellitus presented to the emergency department (ED)
with signs and symptoms corresponding to DKA. Initial pH, HCO3, Na and Cl concentrations were 6.83,
3.6 mmol/l, 143 mmol/l and 122 mmol/l respectively; anion gap 17.4 mmol/l and absent urinary ketones. DKA
regime showed no improvement in the measured parameters nor the patient. The diagnosis changed to hyperchloremic
high-anion gap acidosis and treatment modifications were made by adding sodium bicarbonate infusion.
There was significant improvement in the clinical status of the patient and the calculated parameters.
Discussion: Hyperchloremic acidosis is associated with a non-anion gap, decrease in plasma bicarbonate and
increase in plasma chloride. Rarely, as with this case, it may present with a high-anion gap. The use of bicarbonate
therapy has shown improvement in cases of non-anion gap acidosis however there is very little data to
support its role in high-anion gap hyperchloremic metabolic acidosis
condition like hyperchloremic metabolic acidosis.
Case report: A 20 years old female with type 1 diabetes mellitus presented to the emergency department (ED)
with signs and symptoms corresponding to DKA. Initial pH, HCO3, Na and Cl concentrations were 6.83,
3.6 mmol/l, 143 mmol/l and 122 mmol/l respectively; anion gap 17.4 mmol/l and absent urinary ketones. DKA
regime showed no improvement in the measured parameters nor the patient. The diagnosis changed to hyperchloremic
high-anion gap acidosis and treatment modifications were made by adding sodium bicarbonate infusion.
There was significant improvement in the clinical status of the patient and the calculated parameters.
Discussion: Hyperchloremic acidosis is associated with a non-anion gap, decrease in plasma bicarbonate and
increase in plasma chloride. Rarely, as with this case, it may present with a high-anion gap. The use of bicarbonate
therapy has shown improvement in cases of non-anion gap acidosis however there is very little data to
support its role in high-anion gap hyperchloremic metabolic acidosis
Creator
Esmail Sangey, Kishan Chudasama
Source
www.elsevier.com/locate/afjem
Publisher
afem
Date
2020
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Citation
Esmail Sangey, Kishan Chudasama, “Jurnal Internasional Afrika vol. 10 issue 1 2020
African Journal of Emergency Medicine
High-anion gap hyperchloremic acidosis mimicking diabetic ketoacidosis on initial presentation – Case report,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/2414.
African Journal of Emergency Medicine
High-anion gap hyperchloremic acidosis mimicking diabetic ketoacidosis on initial presentation – Case report,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/2414.