College
Rowan-Virtua School of Osteopathic Medicine
Keywords
Pseudohypobicarbonatemia, Hypertriglyceridemia, Acidosis, Pancreatitis, Lipids
Date of Presentation
5-1-2025 12:00 AM
Poster Abstract
Pseudohypobicarbonatemia is a laboratory artifact in which severe hypertriglyceridemia interferes with enzymatic bicarbonate measurements, leading to falsely low levels that can mimic metabolic acidosis. We present a case of a patient with diabetes and hyperlipidemia who was initially found to have profound hypobicarbonatemia and an elevated anion gap, raising concerns for metabolic acidosis. However, arterial blood gas analysis revealed a normal acid-base status, prompting further investigation and identification of severe hypertriglyceridemia (>1100 mg/dL) as the underlying cause. This case highlights the diagnostic challenges posed by hypertriglyceridemia-induced lab errors and underscores the importance of confirming suspected metabolic acidosis with arterial blood gas analysis. Awareness of pseudohypobicarbonatemia is crucial to prevent unnecessary interventions and ensure accurate clinical decision-making.
Disciplines
Diagnosis | Emergency Medicine | Endocrinology, Diabetes, and Metabolism | Medicine and Health Sciences | Nutritional and Metabolic Diseases | Pathological Conditions, Signs and Symptoms
Included in
Diagnosis Commons, Emergency Medicine Commons, Endocrinology, Diabetes, and Metabolism Commons, Nutritional and Metabolic Diseases Commons, Pathological Conditions, Signs and Symptoms Commons
Recognizing Pseudohypobicarbonatemia in Patients with Hypertriglyceridemia - A Case Report
Pseudohypobicarbonatemia is a laboratory artifact in which severe hypertriglyceridemia interferes with enzymatic bicarbonate measurements, leading to falsely low levels that can mimic metabolic acidosis. We present a case of a patient with diabetes and hyperlipidemia who was initially found to have profound hypobicarbonatemia and an elevated anion gap, raising concerns for metabolic acidosis. However, arterial blood gas analysis revealed a normal acid-base status, prompting further investigation and identification of severe hypertriglyceridemia (>1100 mg/dL) as the underlying cause. This case highlights the diagnostic challenges posed by hypertriglyceridemia-induced lab errors and underscores the importance of confirming suspected metabolic acidosis with arterial blood gas analysis. Awareness of pseudohypobicarbonatemia is crucial to prevent unnecessary interventions and ensure accurate clinical decision-making.
