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Sammanfattning

Acute salicylate poisoning gives rise to a primary respiratory alkalosis and in severe cases, especially among infants, a primary metabolic acidosis. In chronic salicylate poisoning, however, no specific acid-base disturbance is typical according to the limited literature. Four cases are reported here who presented with a pronounced hypokalemia (s-potassium 1.8-2.4 mmol/l) and a severe metabolic alkalosis (a-BE 18-30 mmol/l) of unclear origin. All patients were treated with saline and large amounts of potassium chloride intravenously, which normalised their laboratory values within a few days. The patients denied repeated vomiting but admitted daily overdoses of long duration of salicylates or more specifically a soluble preparation containing 500 mg salicylate and 50 mg caffeine in each tablet. The mechanism underlying the alkalosis in these cases are most probably the drug induced depletion of potassium. We propose that chronic salicylate poisoning may lead to severe metabolic alkalosis, particularly if the abused preparation also contains caffeine and sodium bicarbonate.

MeSH