Korean J Med.  2015 Oct;89(4):457-460. 10.3904/kjm.2015.89.4.457.

A Case of Salicylate-Intoxication-Induced Pseudohyperchloremia

• Kim HJ
• Oh YJ
• Lee JS
• Oh SY
• Lee JY

• KMID: 2268981
• DOI: http://doi.org/10.3904/kjm.2015.89.4.457

Abstract

Despite the increasing use of alternative analgesic agents, salicylate overdose remains a not-uncommon problem. Severe poisoning is life threatening, so prompt treatment and supportive measures are required to reduce mortality. Generally, salicylate intoxication results in the development of high-anion-gap metabolic acidosis. However, outside of Korea, normal-anion-gap or negative-anion-gap metabolic acidosis with hyperchloremia is rarely reported. We report herein the case of an 83-year-old female patient with chronic aspirin intake who presented with hyperchloremia and a negative anion gap. The patient's symptoms improved with conservative treatment and hemodialysis; notably, her chloride levels decreased as her blood salicylate concentrations decreased. Salicylate may cause hyperchloremia, demonstrating the importance of careful documentation of patient medication histories.

Keyword

Salycylate intoxication; Pseudohyperchloremia; Hemodialysis

MeSH Terms

Acid-Base Equilibrium
Acidosis
Aged, 80 and over
Analgesics
Aspirin
Female
Humans
Korea
Mortality
Poisoning
Renal Dialysis
Analgesics
Aspirin