Spurious Hyperchloremia and Decreased Anion Gap in a Patient with Dextromethorphan Bromide
作者:
Yee-Yung Ng,
Wen-Ling Lin,
Tzen-Wen Chen,
Bao-Chemg Lin,
Shin-Hung Tsai,
Ching-Chun Chang,
Tung-Po Huang,
期刊:
American Journal of Nephrology
(Karger Available online 1992)
卷期:
Volume 12,
issue 4
页码: 268-270
ISSN:0250-8095
年代: 1992
DOI:10.1159/000168457
出版商: S. Karger AG
关键词: Hyperchloremia;Bromism;Negative anion gap;Dextromethorphan bromide
数据来源: Karger
摘要:
Although cold syrup containing dextromethorpan bromide is widely administered, the bromism due to cold syrup has not been reported. We report a patient who had negative anion gap with hyperchloremia and conscious loss because of daily intake of cold complex syrup (containing dextromethorphan bromide 0.4 mg/ml, acetaminophen 8.33 mg/ml) for headache for 4-5 years. The bromide content in cold complex syrup resulted in serum levels of bromide that interfered with the automated analyzers for chloride content. When conscious change is due to bromism, hemodialysis instead of forced hydration and diuresis should be performed immediately. Therefore, patients with a markedly negative anion gap with hyperchloremia should be considered as having halide intoxication.
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