1. Gamma-hydroxybutyrate (GHB), an unusual cause of high anion gap metabolic acidosis
- Author
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Stijn Lambrecht, Matthias Desmet, S Carlier, Olivier Heylen, Laurence Carlier, Vincent Van Belleghem, Kathleen Croes, and Frederik Hooft
- Subjects
Male ,Narcotics ,Liquid ecstasy ,Central nervous system ,Gas Chromatography-Mass Spectrometry ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Glasgow Coma Scale ,030212 general & internal medicine ,Depression (differential diagnoses) ,business.industry ,Gamma hydroxybutyrate ,Middle Aged ,medicine.disease ,High anion gap metabolic acidosis ,Alcoholism ,medicine.anatomical_structure ,Anesthesia ,Anesthetic ,Emergency Medicine ,Clinical case ,Acidosis ,Sodium Oxybate ,business ,030217 neurology & neurosurgery ,medicine.drug ,Narcolepsy - Abstract
The causes of high anion gap metabolic acidosis (HAGMA) are well described in the literature. However, sometimes more frequent causes of HAGMA cannot explain its occurrence.In the case of HAGMA and severe neurological depression in the absence of other causes of HAGMA, clinicians should consider an intoxication with gamma-hydroxybutyrate (GHB) as a possible cause.GHB is endogenous to the mammalian central nervous system (CNS). Synthetic GHB was initially used as an anesthetic but is now only licensed for medical use in a limited number of indications such as the treatment of narcolepsy. Because of its euphoric effects, it became popular for recreational use under the street names: Liquid Ecstasy, Georgia Home Boy, and Liquid G.We describe the clinical case of a patient who suffered from severe neurological depression and HAGMA.
- Published
- 2017