Anion Gap and Osmolar Gap (High)

Differential Diagnosis

Toxicological

1. Methanol
2. Ethanol glycol
3. Aspirin (Salicylate) Toxicity
4. Iron
5. INH
6. Paraldehyde
7. Alcoholic Ketoacidosis
8. Inhalants - CN, CO, Hydrogen Sulfide
9. Toluene

Non-Toxicological

1. Lactic Acidosis
2. DKA
3. Uremia

CAT MUDPILERS

• C-Cyanide
• A-ASA, Alcohol
• T-Toluene
• M-Methanol, Metformin
• U-Uremia
• D-DKA
• P-Paraldehyde, Post-ictal lactic acidosis (transient, 60-90 min), Phenformin (withdrawn in 1970s)
• I-Iron, INH, Inhalents, Inborn Errors
• L-Lactic Acidosis
• E-Ethylene glycol, Ethanol
• R-Rhabdomyolysis
• S-Salicylates, Solvents, Starvation

See Also

• Osmolal or Osmolar Gap
• Anion Gap (High)
• Toxidromes