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Related Experiment Videos

False hyperchloremia in bromism.

K Yamamoto1, H Kobayashi, T Kobayashi

  • 1Department of Anesthesiology, School of Medicine, Kanazawa University, Kanazawa, Japan.

Journal of Anesthesia
|January 1, 1991
PubMed
Summary

Phantom limb pain patients may experience falsely high chloride levels due to bromide intoxication. Bromide and iodide ions interfere with ion-specific electrode measurements, leading to inaccurate hyperchloremia readings.

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Area of Science:

  • Clinical Chemistry
  • Toxicology
  • Analytical Chemistry

Background:

  • Plasma chloride concentration is crucial for diagnosing various medical conditions.
  • Ion-specific electrode methods are commonly used for chloride measurement.
  • Potential interferences with ion-specific electrodes can lead to diagnostic errors.

Purpose of the Study:

  • To investigate a case of apparent hyperchloremia due to bromide intoxication.
  • To evaluate the interference of bromide and iodide ions on chloride measurements using ion-specific electrodes.

Main Methods:

  • Case study of a patient with phantom limb pain and pseudohyperchloremia.
  • Laboratory analysis of plasma bromide and chloride concentrations.
  • In vitro testing of fluoride, bromide, and iodide ion interference with chloride measurement by ion-specific electrode.

Main Results:

  • A patient presented with pseudohyperchloremia (251 mEq/L) due to bromide intoxication from analgesic tablets.
  • Plasma bromide levels were toxic, confirming bromide intoxication.
  • Bromide and iodide ions significantly overestimated chloride concentration, while fluoride did not.
  • Discontinuation of analgesics normalized both plasma chloride and bromide levels within three weeks.

Conclusions:

  • Hyperchloremia measured by ion-specific electrodes requires careful interpretation, especially when bromide or iodide intoxication is suspected.
  • Bromide and iodide ions are significant interferents for chloride measurement by ion-specific electrodes.
  • Accurate diagnosis necessitates considering potential interfering substances in laboratory testing.

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