BROMISM REVEALED BY SPURIOUS HYPERCHLOREM IA - 4 CASES

BACKGROUND: When routine blood chemistry shows elevated chloride alone , another anion (bromide, iodine, fluoide) may be involved. USE REPORT S: Hyperchloremia and decreased anion gap was observed in four patient s, Chloremia ranged from 134 to 172 mmol/l al initial blood rests. Car eful history taking led to the discovery of long-term use of calcium b romogalactoglucomate. Specific assay with inductively coupled plasma m ass spectrometry (ICPMS(R)) confirmed the presence of bromide in the b lood. Chloridemia returned to normal levels after discontinuing use of bromine. DISCUSSION: Bromism is not a common diagnosis, Risks include neurological and psychiatric disorders due to bromide diffusion throu gh the blood-brain barrier Clinical manifestations have been described including skin lesions, digestive intolerance, and fever, Bromide is contained in certain prescription drugs, Patients should be warned aga inst the adverse effects of overuse.