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We report a case with spurious hyperchloremia with negative anion gap in a child who was taking potassium bromide for refractory epilepsy. Blood chemistry showed a high chloride level (171?mEq/L) and a negative anion gap (?52?mEq/L). Plasma chloride concentration is measured by an ion-selective electrode method; however the presence of other anions like bromide and iodides can interfere with chloride level and largely overestimates the chloride concentration. Thus hyperchloremia with a negative anion gap is a clue to the diagnosis of halides like bromide and iodide ingestion.
Originally Published In
Case Reports in Critical Care
Chegondi, Madhuradhar and Totapally, Balagangadhar R., "Spurious Hyperchloremia and Negative Anion Gap in a Child with Refractory Epilepsy" (2016). All Faculty. 115.
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