High Anion Gap Metabolic Acidosis after a Suicide Attempt with Cyanide: The Rebirth of Cyanide Poisoning
| Autor: | Chih-Chien Chiu, Che-Fu Chang, Shih-Hua Lin, Jin-Shuen Chen, Chia-Chao Wu, Po-Jen Hsiao, Jenq-Shyong Chan, Wen-Fang Chiang |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
medicine.medical_specialty Cyanide Anion gap Poison control Suicide Attempted Unconsciousness Diagnosis Differential chemistry.chemical_compound Internal Medicine medicine Humans Intensive care medicine Acid-Base Equilibrium Cyanides business.industry Metabolic acidosis General Medicine medicine.disease High anion gap metabolic acidosis chemistry Lactic acidosis Anesthesia Cyanide poisoning Female Acidosis Severe lactic acidosis business |
| Zdroj: | Internal Medicine. 54:1901-1904 |
| ISSN: | 1349-7235 0918-2918 |
| DOI: | 10.2169/internalmedicine.54.4272 |
| Popis: | A 33-year-old woman was admitted to our emergency department in a state of unconsciousness after attempting suicide with unknown substances. Severe metabolic acidosis (pH: 6.81), with a high anion gap (36.2) and high lactate level (20.2 mmol/L), was observed. After four hours of intensive medical treatment, the patient regained consciousness, with a return of the arterial pH to 7.42. Finally, cyanide intoxication was diagnosed based on the detection of a serum cyanide level of 3.5 mg/L. The presence of a high anion gap associated with severe lactic acidosis is a clue for making a rapid differential diagnosis of acute cyanide intoxication. Providing intensive and immediate supportive management is also crucial, even in cases without obtainable specific antidotes. |
| Databáze: | OpenAIRE |
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