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J Med Toxicol. 2013 Sep;9(3):274-7. doi: 10.1007/s13181-013-0305-z.

Severe anion gap acidosis associated with intravenous sodium thiosulfate administration.

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1
Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic Rochester, Rochester, MN, USA.

Abstract

INTRODUCTION:

Severe anion gap (AG) acidosis associated with intravenous sodium thiosulfate (STS) administration has not been previously described in nondialysis chronic kidney disease (CKD) patients.

CASE REPORT:

We present a CKD patient with a baseline creatinine 1.8 mg/dL (eGFR 28 ml/min/1.73 m²) who developed sustained and life-threatening AG acidosis associated with intravenous STS treatment for calciphylaxis.

DISCUSSION:

Although marketed as a safe drug, STS can cause life-threatening acidosis as illustrated in this case. STS-induced AG acidosis should be considered in the differential diagnosis of severe acidosis in patients receiving STS. Dosage adjustment and close follow-up of patients' acid-base status after STS initiation is necessary.

PMID:
23636659
PMCID:
PMC3770999
DOI:
10.1007/s13181-013-0305-z
[Indexed for MEDLINE]
Free PMC Article
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