{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T09:46:53Z","timestamp":1766137613786,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,1,14]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>A 76-year-old man was found unresponsive and brought to the emergency department. Initial workup showed profound lactic acidosis on a point-of-care arterial blood gas, without clinical signs of hypoperfusion. Investigations for types A and B lactic acidosis revealed no unifying diagnosis to explain both his altered mental status and profound lactic acidosis. A toxicology workup revealed an increased osmolar gap and an elevated ethylene glycol level. The lactic acidosis and his mental status completely normalised within 8\u2009hours of renal replacement therapy initiation and fomepizole administration. Ethylene glycol metabolites have similar molecular structure with L-lactate. Some blood gas analysers are unable to differentiate them, resulting in an artefactual lactate elevation. Our case highlights the importance of recognising a falsely elevated lactate, which should raise clinical suspicion of ethylene glycol poisoning, as the treatment is time-sensitive to prevent complications and mortality.<\/jats:p>","DOI":"10.1136\/bcr-2020-239936","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T11:37:57Z","timestamp":1612957077000},"page":"e239936","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Spurious point-of-care lactate elevation in ethylene glycol intoxication: rediscovering a clinical pearl"],"prefix":"10.1136","volume":"14","author":[{"given":"Laurence","family":"Poirier-Blanchette","sequence":"first","affiliation":[{"name":"Department of Medicine, McGill University Faculty of Medicine, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camille","family":"Simard","sequence":"additional","affiliation":[{"name":"Department of Medicine, McGill University Faculty of Medicine, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blair Carl","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Medicine, McGill University Faculty of Medicine, Montreal, Quebec, Canada"},{"name":"Division of General Internal Medicine, Jewish General Hospital, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,2,10]]},"reference":[{"key":"2025082711265275000_14.2.e239936.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2013.06.012"},{"key":"2025082711265275000_14.2.e239936.2","doi-asserted-by":"publisher","DOI":"10.1080\/09553002.2019.1589653"},{"key":"2025082711265275000_14.2.e239936.3","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410160409"},{"key":"2025082711265275000_14.2.e239936.4","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1056\/NEJMra1615295","article-title":"Toxic alcohols","volume":"378","author":"Kraut","year":"2018","journal-title":"N Engl J Med"},{"key":"2025082711265275000_14.2.e239936.5","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/j.ccc.2012.07.002","article-title":"Methanol and ethylene glycol intoxication","volume":"28","author":"Kruse","year":"2012","journal-title":"Crit Care Clin"},{"key":"2025082711265275000_14.2.e239936.6","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.061288"},{"key":"2025082711265275000_14.2.e239936.7","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1093\/clinchem\/46.6.874","article-title":"Interference by glycolic acid in the Beckman synchron method for lactate: a useful clue for unsuspected ethylene glycol intoxication","volume":"46","author":"Porter","year":"2000","journal-title":"Clin Chem"},{"key":"2025082711265275000_14.2.e239936.8","doi-asserted-by":"publisher","DOI":"10.1080\/15563650802432954"},{"key":"2025082711265275000_14.2.e239936.9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/5238240","article-title":"Lactate gap: a diagnostic support in severe metabolic acidosis of unknown origin","volume":"2018","author":"Hauvik","year":"2018","journal-title":"Case Rep Med"},{"key":"2025082711265275000_14.2.e239936.10","first-page":"1","article-title":"Ethylene glycol poisoning: an unusual cause of altered mental status and the lessons learned from management of the disease in the acute setting","volume":"2016","author":"Singh","year":"2016","journal-title":"Case Rep Crit Care"},{"key":"2025082711265275000_14.2.e239936.11","doi-asserted-by":"publisher","DOI":"10.1177\/0004563213506697"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-239936","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:26:58Z","timestamp":1756319218000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-239936"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2,10]]},"published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1136\/bcr-2020-239936"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-239936","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,2]]}}}