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Hiromi Himuro, Takashi Sugiyama, Hidekazu Nishigori, Masatoshi Saito, Satoru Nagase, Junichi Sugawara and Nobuo Yaegashi

.5 °C. Physical examination showed Kussmaul breathing with ketotic odor. The laboratory findings are summarized in Table 1 . Importantly, anion gap showed 21.9, suggesting presence of metabolic acidosis. No obvious non-reassuring fetal status was

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Prashanth Rawla, Anantha R Vellipuram, Sathyajit S Bandaru and Jeffrey Pradeep Raj

sugar levels (<300 mg/dL) along with a plasma bicarbonate level of <10 mmol/L at presentation ( 2 ). Later, normoglycemia was redefined as <250 mg/dL. Thus, EDKA is defined as a triad comprising high anion gap metabolic acidosis with positive serum and

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Gordon Sloan, Amjad Ali and Jonathan Webster

Background Ketoacidosis is a common cause of raised anion gap metabolic acidosis. It most frequently occurs in individuals with type 1 diabetes. Starvation commonly causes ketosis but rarely ketoacidosis. Ketoacidosis is more common when women

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Miriam Hinaa Ahmad and Ismat Shafiq

day of consolidation chemotherapy, she developed abdominal pain, nausea and vomiting. Her initial laboratory work up upon arrival to the emergency department (ED) showed a blood glucose of 693 mg/dL (normal range (NR): 60–99 mg/dL), anion gap: 28 mg

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Runa Acharya and Udaya M Kabadi

–110); HCO 3 − : <10 mM/L (normal: 20–31); anion gap: 50 mM/L (normal: 8–16); serum urea nitrogen: 36 mg/dL (normal: 7–20); serum creatinine: 2.7 mg/dL (normal: 0.6–1.2); random serum glucose: 255 mg/dL (normal: 79–139, diabetes: >200); serum osmolarity: 308

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Anil Piya, Jasmeet Kaur, Alan M Rice and Himangshu S Bose

. After two months of the treatment, the patient’s creatinine levels were below the normal range (0.23 mg/dL), and his chloride was 111 mM, which was a little above the normal range of 98–107 mM. The anion gap was 7.5 (L), which is much lower than the

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Sebastian Hörber, Sarah Hudak, Martin Kächele, Dietrich Overkamp, Andreas Fritsche, Hans-Ulrich Häring, Andreas Peter and Martin Heni

reduced blood pH of <7, a high serum anion gap (41 mEq/dL), markedly elevated blood glucose (1687 mg/dL/93.6 mmol/L), elevated lactate of 5.1 mg/dL and serum osmolality of 404 mosmol/kg. The urine sample was clearly positive for ketones and glucose. A drug

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Jose León Mengíbar, Ismael Capel, Teresa Bonfill, Isabel Mazarico, Laia Casamitjana Espuña, Assumpta Caixàs and Mercedes Rigla

increased anion gap metabolic acidosis (pH: 7.13, HCO 3 − : 11.9 mEq/L, anion gap: 21 mEq/L) associated with ketosis (beta-hydroxybutyrate in capillary blood: 6.0 mmol/L). Other metabolic derangements (hyponatraemia and hyperkalaemia) were related to DKA

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Mohammed Faraz Rafey, Arslan Butt, Barry Coffey, Lisa Reddington, Aiden Devitt, David Lappin and Francis M Finucane

.6–6) and lactate was 0.8 mmol/L (<0.8) with a high anion gap of 33.8 mEq/L (8–16), consistent with a metabolic acidosis with partial respiratory compensation. A diagnosis of EDKA induced by the SGLT2i canagliflozin was made. Case 2: A 59-year-old white

Open access

Senhong Lee, Aparna Morgan, Sonali Shah and Peter R Ebeling

anion gap of 36.7 mEq/L (8–16 mEq/L). On further questioning, he described two-day history of lethargy, polyuria and polydipsia associated with elevated BGL readings at home (between 20 and 30 mmol/L). In this setting, his local medical officer had