MELISSA J. SCHIFF, M.D.; ANTHONY L. SUCHMAN, M.D.
To the editor: A recent report (1) has described falsely low serum chloride values measured by the Kodak Ektachem Analyzer (Eastman Kodak Co., Rochester, New York). We report three additional cases.
A 64-year-old woman with diabetes mellitus, hypertension, and atherosclerotic cardiovascular disease was hospitalized for exacerbation of congestive heart failure. While continuing her usual doses of digoxin, insulin, prazosin, diltiazem, procainamide, and allopurinol (300 mg/d), she was treated vigorously with furosemide and metolazone, resulting in azotemia (creatinine level, 3.8 mg/dL). Her serum chloride level was reported to be 67 mg/dL with a calculated anion gap of 33. However, her PCO2
SCHIFF MJ, SUCHMAN AL. Spurious Hypochloremia and Renal Insufficiency. Ann Intern Med. 1985;102:420–421. doi: 10.7326/0003-4819-102-3-420_2
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Published: Ann Intern Med. 1985;102(3):420-421.
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