Section 5.11
Clinical Chemistry Problem Solving

A patient presents to the emergency department with symptoms of intoxication including impaired speech and movement. The plasma osmolality was measured and found to be 330 mOs/kg. The osmolal gap was 40 mOsm/Kg. A blood alcohol was measured by the alcohol dehydrogenase method and found to be 0.15% w/v (150 mg/dL). Electrolyte results showed an increased anion gap. Ethylene glycol intoxication was suspected because the osmolal gap was greater than could be explained by ethanol alone, but gas chromatography was not available. Which of the following would be abnormal if this suspicion proved correct?