It is quite acceptable to add on tests to explain an
abnormal biochemical finding (a very high osmolar gap
in this case) which may be the underlying cause of
reduced level of consciousness. The absence of
acidosis makes methanol and polyethylene glycol
poisoning unlikely. Ethanol and isopropyl alcohol
intoxications are compatible with this scenario and
since ethanol was only 10 mg/dL, isopropyl alcohol
poisoning is the most likely diagnosis.
regards
Mohammad
--- [log in to unmask] wrote: > 24 yr old
male, reduced level of consciousness (like
> the consultant who
> took the telephone call!)
>
> Request at 1am Monday morning
>
> Osmotic gap = 100 (U+E, urea, glucose = normal). No
> acidosis or anion gap.
>
> ?ethanol but..
>
> Plasma ethanol = 10 mg/dl (on fluoride oxalate
> sample) measured on the
> admission sample the next day
>
> I would be interested on other people's views about
> the use of the osmotic
> gap in making decisions about toxin ingestion on
> call at a DGH.
> Should ethanol be measured in these kinds of cases
> on call?
>
> Thanks
>
> Rob
>
>
> Dr Robert Lord
> Department of Clinical Biochemistry
> Rotherham District General Hospital
> Moorgate Road
> Oakwood
> Rotherham
> S60 2UD
>
> Tel 01709 820000
>
> E mail [log in to unmask]
>
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=====
Dr. M A Al-Jubouri
Consultant Chemical Pathologist
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------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
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http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
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