• Ann. Clin. Biochem. · Mar 2015

    Case Reports

    Near-fatal persistent anion- and osmolal-gap acidosis due to massive gamma-butyrolactone/ethanol intoxication.

    • Luc Heytens, Hugo Neels, Niels Van Regenmortel, Wim van den Brink, Manu Henckes, Sofie Schouwers, Greet Dockx, and Cleo L Crunelle.
    • Department of Intensive Care, Sint-Augustinus Hospital, Wilrijk, Belgium luc.heytens@gza.be.
    • Ann. Clin. Biochem. 2015 Mar 1; 52 (Pt 2): 283-7.

    AbstractWe report a case of an ethanol and massive gamma-butyrolactone (GBL) intoxication, the precursor of the recreational drug gamma-hydroxybutyric acid (GHB), resulting in life-threatening metabolic acidosis (pH 6.5) with a highly increased anion- and osmolal gap. Rapid analysis using gas chromatography revealed a GHB plasma concentration of 4400 mg/L, far above the upper limit concentration of 1000 mg/L found in adult fatalities attributed to GBL. Full recovery was established following supportive treatment including haemodialysis. This is the first report of a combined ethanol/GBL intoxication as a cause of high serum anion- and osmolal-gap metabolic acidosis.© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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