Absence of high anion gap metabolic acidosis in severe ethylene glycol poisoning: a potential effect of simultaneous lithium carbonate ingestion.

Ethylene glycol poisoning is accompanied by a high anion gap metabolic acidosis. We describe a case of severe ethylene glycol poisoning in which severe acidosis was not present. This appears to be due to a beneficial effect exerted by simultaneous ingestion of 80 lithium carbonate tablets, each containing approximately 4 mEq carbonate, with a potential bicarbonate load of 320 mEq. We postulate a protective effect of lithium carbonate due to the bicarbonate generated by this substance.