To the Editor: As clinical toxicologists, we recommend a fewadditions and corrections to the causes of anion-gap metabolicacidosis that are listed in the case of ethylene glycol poisoningdescribed by Takayesu et al. (March 9 issue).1 Propylene glycol,which is used as a diluent in many medications, including lorazepam,is metabolized to lactate, and patients with propylene glycoltoxicity can present with elevated anion gaps as well as osmolalgaps.2 Massive ingestions of analgesics (e.g., acetaminophenand nonsteroidal antiinflammatory drugs) may produce anion-gapacidosis.3,4 Salicylates, mentioned as a cause of anion-gapmetabolic acidosis in both Table 2 and . . . [Full Text of this Article]
Previous
