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Rapid analysis using gas chromatography revealed a GHB plasma concentration of 4400\u2009mg\/L, far above the upper limit concentration of 1000\u2009mg\/L found in adult fatalities attributed to GBL. Full recovery was established following supportive treatment including haemodialysis. This is the first report of a combined ethanol\/GBL intoxication as a cause of high serum anion- and osmolal-gap metabolic acidosis.<\/jats:p>","DOI":"10.1177\/0004563214553278","type":"journal-article","created":{"date-parts":[[2014,9,10]],"date-time":"2014-09-10T02:35:12Z","timestamp":1410316512000},"page":"283-287","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Near-fatal persistent anion- and osmolal-gap acidosis due to massive gamma-butyrolactone\/ethanol intoxication"],"prefix":"10.1177","volume":"52","author":[{"given":"Luc","family":"Heytens","sequence":"first","affiliation":[{"name":"Department of Intensive Care, Sint-Augustinus Hospital, Wilrijk, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugo","family":"Neels","sequence":"additional","affiliation":[{"name":"Toxicological Center, University of Antwerp, Antwerp, Belgium"},{"name":"Laboratory for Clinical Chemistry and Toxicology, ZNA Stuivenberg, Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niels","family":"Van Regenmortel","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, ZNA Stuivenberg, Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wim","family":"van den Brink","sequence":"additional","affiliation":[{"name":"Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manu","family":"Henckes","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Sint-Augustinus Hospital, Wilrijk, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofie","family":"Schouwers","sequence":"additional","affiliation":[{"name":"Clinical Laboratory, Sint-Augustinus Hospital, Wilrijk, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greet","family":"Dockx","sequence":"additional","affiliation":[{"name":"Laboratory for Clinical Chemistry and Toxicology, ZNA Stuivenberg, Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cleo L","family":"Crunelle","sequence":"additional","affiliation":[{"name":"Toxicological Center, University of Antwerp, Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2014,9,9]]},"reference":[{"key":"bibr1-0004563214553278","doi-asserted-by":"publisher","DOI":"10.1515\/CCLM.2004.252"},{"key":"bibr2-0004563214553278","doi-asserted-by":"publisher","DOI":"10.2174\/13816128113199990624"},{"key":"bibr3-0004563214553278","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/29.6.582"},{"key":"bibr4-0004563214553278","first-page":"534","volume":"134","author":"Liechti ME","year":"2004","journal-title":"Swiss Med Wkly"},{"key":"bibr5-0004563214553278","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(98)70230-6"},{"key":"bibr6-0004563214553278","doi-asserted-by":"publisher","DOI":"10.1081\/CLT-120004400"},{"key":"bibr7-0004563214553278","doi-asserted-by":"publisher","DOI":"10.1016\/j.disamonth.2004.01.002"},{"key":"bibr8-0004563214553278","doi-asserted-by":"publisher","DOI":"10.1081\/CLT-53083"},{"key":"bibr9-0004563214553278","doi-asserted-by":"publisher","DOI":"10.1007\/s00216-013-7586-6"},{"key":"bibr10-0004563214553278","doi-asserted-by":"publisher","DOI":"10.1080\/15563650701365818"}],"container-title":["Annals of Clinical Biochemistry: International Journal of Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0004563214553278","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0004563214553278","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0004563214553278","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:21:57Z","timestamp":1777378917000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0004563214553278"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9,9]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015,3]]}},"alternative-id":["10.1177\/0004563214553278"],"URL":"https:\/\/doi.org\/10.1177\/0004563214553278","relation":{},"ISSN":["0004-5632","1758-1001"],"issn-type":[{"value":"0004-5632","type":"print"},{"value":"1758-1001","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9,9]]}}}