Table 1

Characteristics of the patient on admission

Symptoms and signsInvestigations
*Anion gap = sodium−chloride−bicarbonate.
Weakness, nausea, slurred speech, lethargic and hostile, blood pressure 75/50 mm Hg on sitting, ataxia, dehydration, asterixispH 7.21
Potassium 4.9 mmol/l
Sodium 140 mmol/l
Chloride 110 mmol/l
Bicarbonate 6 mmol/l
D(−)-lactate level 5.23 mmol/l
Anion gap 24*