Case Report
Diagnostic Challenge in a Patient with Severe Anion Gap Metabolic Acidosis
Table 1
Admission laboratory values.
| Laboratory | Value | Reference |
| Hemoglobin | 11.5 g/dL | 12.0–15.5 g/dL | Hematocrit | 35.2% | 34.9–44.5% | Leukocytes | 26.6 × 103 cells/uL | 3.4–10.5 × 103 cells/uL | Leukocyte differential | 85.6% neutrophils, 7.5% lymphocytes, 6.8% monocytes, 0% eosinophils, and 0.1% basophils | 41–77% neutrophils, 20–45% lymphocytes, 0–12% monocytes, 0–6% eosinophils, and 0–2% basophils | Platelets | 298 × 103 cells/uL | 150–450 × 103 cells/uL | INR | 1.3 | 0.8–1.2 | Prothrombin time | 17.0 seconds | 9.5–13.8 seconds | Sodium | 138 mM/L | 136–148 mM/L | Potassium | 7.5 mM/L | 3.5–5.0 mM/L | Creatinine | 2.1 mg/dL | 0.6–1.1 mg/dL | Blood urea nitrogen | 52.6 mg/dL | 6.0–21.0 mg/dL | Chloride | 111 mmol/L | 100–108 mmol/L | Bicarbonate | 5.8 mmol/L | 21–32 mmol/L | Calcium | 8.8 mg/dL | 8.4–10.4 mg/dL | Total protein | 7.4 g/dL | 6.3–8.2 g/dL | Magnesium | 2.3 mg/dL | 1.6–2.3 mg/dL | Alkaline phosphatase | 83 IU/L | 55–142 IU/L | AST | 41 IU/L | 15–46 IU/L | ALT | 41 IU/L | 10–43 IU/L | Total bilirubin | <0.40 mg/dL | 0.10–1.00 mg/dL | Blood and urine cultures | No growth | No growth |
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