High anion gap metabolic acidosis - Wikipedia High anion gap metabolic acidosis When acidosis is present on blood tests, the first step in determining the cause is determining the anion gap. If the anion gap is high ( > 12 mEq / L ), there are several potential causes. This article provides insufficient context for those unfamiliar with the subject. Please help improve the article with a good introductory style. ( February 2014 ) High anion gap metabolic acidosis Classification and external resources Specialty endocrinology ICD - 10 E87. 2 ICD - 9 - CM 276.2 DiseasesDB 15112 ( edit on Wikidata ) High anion gap metabolic acidosis is a form of metabolic acidosis characterized by a high anion gap ( a medical value based on the concentrations of ions in a patient 's serum ). An anion gap is usually considered to be high if it is over 12 mEq / L. High anion gap metabolic acidosis is caused generally by acid produced by the body,. More rarely, high anion gap metabolic acidosis may be caused by ingesting methanol or overdosing on aspirin. The Delta Ratio is a formula that can be used to assess elevated anion gap metabolic acidosis and to evaluate whether mixed acid base disorder ( metabolic acidosis ) is present. The list of agents that cause high anion gap metabolic acidosis is similar to but broader than the list of agents that cause a serum osmolal gap. Contents 1 Causes 1.1 Other 2 Diagnosis 3 Management 4 See also 5 References Causes This section 's tone or style may not reflect the encyclopedic tone used on Wikipedia. See Wikipedia 's guide to writing better articles for suggestions. ( April 2017 ) Causes include : The newest mnemonic was proposed in The Lancet reflecting current causes of anion gap metabolic acidosis : G -- glycols ( ethylene glycol & propylene glycol ) O -- oxoproline, a metabolite of paracetamol L -- L - lactate, the chemical responsible for lactic acidosis D -- D - lactate M -- methanol A -- aspirin R -- renal failure K -- ketoacidosis, ketones generated from starvation, alcohol, and diabetic ketoacidosis The mnemonic MUDPILES is commonly used to remember the causes of increased anion gap metabolic acidosis. M -- Methanol U -- Uremia ( chronic kidney failure ) D -- Diabetic ketoacidosis P -- Paracetamol, Propylene glycol ( used as an inactive stabilizer in many medications ; historically, the `` P '' also stood for Paraldehyde, though this substance is not commonly used today ) I -- Infection, Iron, Isoniazid ( which can cause lactic acidosis in overdose ), Inborn errors of metabolism ( an especially important consideration in pediatric patients ) L -- Lactic acidosis E -- Ethylene glycol ( Note : Ethanol is sometimes included in this mnemonic as well, although the acidosis caused by ethanol is actually primarily due to the increased production of lactic acid found in such intoxication. ) S -- Salicylates Another frequently used mnemonic is KARMEL. K -- Ketoacidosis A -- aspirin R -- Renal failure M -- Methanol E -- Ethylene glycol L -- Lactic acidosis Another frequently used mnemonic is KULT. K -- Ketoacidosis ( DKA, Alcoholic ketoacidosis, AKA ) U -- Uremia L -- Lactic acidosis T -- Toxins ( Ethylene glycol, methanol, as well as drugs, such as aspirin, Metformin ) The preferred mnemonic of D. Robert Dufour, the chief of the Pathology and Laboratory Medicine Service, Veterans Affairs Medical Center, is DUMPSALE, which omits the I of MUDPILES as the proposed values of * I * are exceedingly rare in clinical practice. D -- Diabetic ketoacidosis U -- Uremia M -- Methanol P -- Paraldehyde S -- Salicylates A -- Alcoholic ketoacidosis L -- Lactic acidosis E -- Ethylene Glycol The mnemonic for the ( rare, in comparison ) toxins is ACE GIFTs : Aspirin, Cyanide, Ethanolic ketosis, Glycols ( ethylene and propylene ), Isoniazid, Ferrous iron, Toluene. Most of these cause a lactic acidosis. Other formaldehyde toluene sulfates metformin rhabdomyolysis Diagnosis This section is empty. You can help by adding to it. ( November 2017 ) Management This section is empty. You can help by adding to it. ( November 2017 ) See also Normal anion gap acidosis References Jump up ^ `` Anion Gap ( Blood ) ''. University of Rochester Medical Center. Retrieved 2014 - 02 - 18. Jump up ^ Sabatini, S. ; Kurtzman, N.A. ( 2008 ). `` Bicarbonate Therapy in Severe Metabolic Acidosis ''. Journal of the American Society of Nephrology. 20 ( 4 ) : 692 -- 5. doi : 10.1681 / asn. 2007121329. PMID 18322160. Jump up ^ Mehta, Ankit N ; Emmett, Joshua B ; Emmett, Michael ( 2008 ). `` GOLD MARK : An anion gap mnemonic for the 21st century ''. The Lancet. 372 ( 9642 ) : 892. doi : 10.1016 / S0140 - 6736 ( 08 ) 61398 - 7. PMID 18790311. Jump up ^ Medical Mnemonics.com : 1203 3255 Jump up ^ Anion Gap : Acid Base Tutorial, University of Connecticut Health Center Jump up ^ Carmody, J Bryan ; Norwood, Victoria F ( 2012 ). `` A clinical approach to paediatric acid -- base disorders ''. Postgraduate Medical Journal. 88 ( 1037 ) : 143 -- 51. doi : 10.1136 / postgradmedj - 2011 - 130191. PMID 22267531. Jump up ^ `` Metabolic Acidosis, Stepwise Approach to ABGs : Acid Base Tutorial, University of Connecticut Health Center ''. fitsweb.uchc.edu. Retrieved 2017 - 04 - 18. Jump up ^ Chang, Chin - Tung ; Chen, Yung - Chang ; Fang, Ji - Tseng ; Huang, Chiu - Ching ( 2009 ). `` High Anion Gap Metabolic Acidosis in Suicide : Do n't Forget Metformin Intoxication -- Two Patients ' Experiences ''. Renal Failure. 24 ( 5 ) : 671 -- 5. doi : 10.1081 / JDI - 120013973. PMID 12380915. Jump up ^ `` Metabolic Acidosis : Acid - Base Regulation and Disorders : Merck Manual Professional ''. Retrieved 2008 - 12 - 04. Electrolyte imbalance and acid -- base imbalance ( E86 -- E87, 276 ) Volume status Volume contraction ( dehydration / hypovolemia ) Hypervolemia Electrolyte Sodium High Hypernatremia Salt poisoning Low Hypotonic Isotonic Potassium High Low Chloride High Low Calcium High Low Acid -- base Acidosis Metabolic : High anion gap Ketoacidosis Diabetic ketoacidosis Alcoholic ketoacidosis Lactic Normal anion gap Hyperchloremic Renal tubular Respiratory Alkalosis Metabolic Contraction alkalosis Respiratory Both Mixed disorder of acid - base balance Retrieved from `` https://en.wikipedia.org/w/index.php?title=High_anion_gap_metabolic_acidosis&oldid=830395177 '' Categories : Biochemistry Mnemonics Metabolic disorders Kidney diseases Hidden categories : Wikipedia articles needing context from February 2014 All Wikipedia articles needing context Wikipedia introduction cleanup from February 2014 All pages needing cleanup Infobox medical condition Wikipedia articles needing style editing from April 2017 All articles needing style editing All articles with unsourced statements Articles with unsourced statements from December 2016 Articles with unsourced statements from August 2017 Articles to be expanded from November 2017 All articles to be expanded Articles with empty sections from November 2017 All articles with empty sections Articles using small message boxes Talk Contents About Wikipedia Português Edit links This page was last edited on 14 March 2018, at 15 : 31. 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Question: what causes your anion gap to be high
Answer: acid produced by the body