Archives of pathology & laboratory medicine
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Arch. Pathol. Lab. Med. · Jan 1989
Case ReportsFatal iatrogenic salicylate intoxication in a long-term user of enteric-coated aspirin.
A 64-year-old woman, who was taking long-term enteric-coated aspirin therapy for rheumatoid arthritis, was prescribed approximately twice her normal dosage (7.1 g daily) during a ten-day convalescence following surgery. Although she presented with features mimicking sepsis, biochemical analysis, ie, a spuriously high carbon dioxide content, suggested salicylate intoxication (admission salicylate concentration, 5.13 mmol/L). She died on the third day after admission. ⋯ The metabolism of salicylate, particularly its excretion kinetics, can make small upward dosage adjustments hazardous. Salicylate has widespread metabolic effects that can mimic other medical conditions, leading to delayed diagnosis of salicylate intoxication. Increased mortality and morbidity may result.