An unusual cause of metabolic alkalosis: hiding in plain sight.


Journal

BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793

Informations de publication

Date de publication:
23 07 2020
Historique:
received: 01 04 2020
accepted: 20 07 2020
entrez: 25 7 2020
pubmed: 25 7 2020
medline: 14 10 2021
Statut: epublish

Résumé

Sodium bicarbonate, in the form of baking soda, is widely used as a home remedy, and as an additive for personal and household cleaning products. Its toxicity has previously been reported following oral ingestion in the setting of dyspepsia. However, its use as a non-ingested agent, like a toothpaste additive, has not been reported as a potential cause of toxicity. We are reporting a case of an 80-year-old woman who presented with chronic metabolic alkalosis and hypokalemia secondary to exogenous alkali exposure from baking soda as a toothpaste additive, which might have represented an underreported ingestion of the substance. Considering that one teaspoon of baking soda provides approximately 59 m-equivalents (mEq) of bicarbonate, specific questioning on its general use should be pursued in similar cases of chloride resistant metabolic alkalosis.

Sections du résumé

BACKGROUND
Sodium bicarbonate, in the form of baking soda, is widely used as a home remedy, and as an additive for personal and household cleaning products. Its toxicity has previously been reported following oral ingestion in the setting of dyspepsia. However, its use as a non-ingested agent, like a toothpaste additive, has not been reported as a potential cause of toxicity.
CASE PRESENTATION
We are reporting a case of an 80-year-old woman who presented with chronic metabolic alkalosis and hypokalemia secondary to exogenous alkali exposure from baking soda as a toothpaste additive, which might have represented an underreported ingestion of the substance.
CONCLUSIONS
Considering that one teaspoon of baking soda provides approximately 59 m-equivalents (mEq) of bicarbonate, specific questioning on its general use should be pursued in similar cases of chloride resistant metabolic alkalosis.

Identifiants

pubmed: 32703174
doi: 10.1186/s12882-020-01967-7
pii: 10.1186/s12882-020-01967-7
pmc: PMC7379761
doi:

Substances chimiques

Chlorides 0
Toothpastes 0
Sodium Bicarbonate 8MDF5V39QO

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

296

Références

J Emerg Med. 2011 Apr;40(4):e71-4
pubmed: 18164162
Am J Kidney Dis. 2012 Apr;59(4):577-81
pubmed: 22265393
J Clin Pharm Ther. 2014 Feb;39(1):73-7
pubmed: 24313600

Auteurs

Carmen Elena Cervantes (CE)

Department of Medicine, Division of Nephrology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. ccervan2@jhmi.edu.

Steven Menez (S)

Department of Medicine, Division of Nephrology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Bernard G Jaar (BG)

Department of Medicine, Division of Nephrology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA.
Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Nephrology Center of Maryland, Baltimore, MD, USA.

Mohamad Hanouneh (M)

Department of Medicine, Division of Nephrology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA.

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Classifications MeSH