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Previous Volume 354:1065-1072 March 9, 2006 Number 10 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Presentation of Case

A 47-year-old man was transferred to the emergency department of this hospital at 10 a.m. on a day in early June because of altered mental status and acute renal failure. At approximately 8 p.m. the previous evening, the patient had been behaving normally at dinner with his family. After dinner, he went outside to work on his car. According to his wife, when he later returned to the house, his speech was slurred and he was lethargic. By 9 p.m., the patient was vomiting and becoming increasingly lethargic. He went to bed, and at 3:30 a.m., his wife found him . . . [Full Text of this Article]

Differential Diagnosis

The Anion Gap

Causes and Effects of Anion-Gap Metabolic Acidosis

Dr. J. Kimo Takayesu's Diagnosis

Pathological Discussion

Discussion of Management

Final Diagnosis

Source Information

From the Department of Surgery (J.K.T.) and the Nephrology Division, Department of Medicine (H.B.), Massachusetts General Hospital; and the Department of Surgery (J.K.T.), the Nephrology Division, Department of Medicine (H.B.), and the Nephrology Division, Department of Pediatrics (M.L.), Harvard Medical School.

Related Letters:

Case 7-2006: A Man with Altered Mental Status and Acute Renal Failure
Maloney G. Jr., Thompson T., Mycyk M., Geoghegan J., Bleasdale J. P., Bradberry S. M., Schmitt R., Zhu X., Ishibe S., Takayesu J. K., Bazari H., Linshaw M.
Extract | Full Text | PDF  
N Engl J Med 2006; 354:2727-2729, Jun 22, 2006. Correspondence

This article has been cited by other articles:

• Kraut, J. A., Kurtz, I. (2008). Toxic Alcohol Ingestions: Clinical Features, Diagnosis, and Management. CJASN 3: 208-225 [Abstract] [Full Text]  
• Maloney, G. Jr., Thompson, T., Mycyk, M., Geoghegan, J., Bleasdale, J. P., Bradberry, S. M., Schmitt, R., Zhu, X., Ishibe, S., Takayesu, J. K., Bazari, H., Linshaw, M. (2006). Case 7-2006: a man with altered mental status and acute renal failure.. NEJM 354: 2727-2729 [Full Text]