A 61-year-old man presented with an increased anion-gap metabolic acidosis, an increased serum osmolal
gap, and a negative result in an alcohol screen.
Urinary electrolytes and osmolal
gap may be useful in assessment of metabolic alkalosis and normal AG metabolic acidosis.
The American Academy of Toxicology recommends treatment with ethanol (or fomepizole if available) in the presence of a methanol level >20 mg/dl, a documented history of methanol ingestion with a serum osmolal
gap >10 mOsm/l or strong clinical suspicion of methanol poisoning with at least two of the following: arterial pH <7.
Ethylene glycol poisoning with a normal anion gap caused by concurrent ethanol ingestion: Importance of the osmolal
gap 10 Ethanol alcohol level Negative Acetaminophen level (mcg/mL) -3 Serum ketones (dilution) 1:8 Urine creatinine (mg/100 mL) 36 Urine anion gap (mmol/L) 49.
Laboratory abnormalities include hypoglycemia, increased serum osmolal
gap, severe anion gap metabolic acidosis, and anemia.
means roughly 'osmotically effective moles of solute per kg of water'.
The serum osmolal
gap (75 mOsm/kg) was calculated as follows: Osmolal
gap = freezing-point depression osmometer value --(2 X [[Na.
Cerebral depression due to propylene glycol in a patient with chronic epilepsy: The value of the plasma osmolal
gap in diagnosis.
AKA can also be associated with other laboratory abnormalities, such as increased serum lactate and an osmolal
gap, as well as reduced electrolyte concentrations.
Severe acute VPA toxicity may be characterized by several biochemical abnormalities, including hyperammonemia, hypernatremia, hypocalcemia, an increased osmolal
and anion gap, respiratory alkalosis, metabolic acidosis, and increased transaminase activity.
gap (OG)  is calculated in the emergency department (ED) when ingestion of ethylene glycol, methanol, isopropyl alcohol, acetone, or other osmotically active substances are suspected.