Spurious Hyperchloremia and Negative Anion Gap in a Child with Refractory Epilepsy

Table 1

This table shows serial electrolytes, anion gap, and calculated serum osmolality.

Serum parameter	Day of admission
	Day 1	Day 2	Day 3	Day 4
Sodium mEq/L	143	143	136	138
Potassium mEq/L	4.2	4.7	4.4	4.4
Chloride mEq/L	171	162	154	154
Bicarbonate mEq/L	24	26	22	25
Glucose mg/dL	97	93	180	96
BUN mg/dL	12	3	3	4
Creatinine mg/dL	0.5	0.4	0.3	0.4
Calcium mg/dL	9.2	9.2	8.3	9
Anion gap mEq/L	−52	−43	−40	−41
Calculated osmolality mOsm/Kg	295	292	283	281
Bromide level mcg/mL	691