A patient with an excessive intake of a halide such as bromide, fluoride or iodide may present with apparent hyperchloremia and a negative anion gap.
Methods of determining chloride that may give falsely high readings in the presence of a halide:
(1) ion specific electrode
(2) thiocyanate method
(1) apparent hyperchloremia
(2) low or negative anion gap (while the instrument may be fooled, the body is not)
(3) history of bromide, iodide or fluoride intake/exposure (which may need to be specifically looked for)
(4) presence of the halide on specific assay
The presence of unexplained hyperchloremia should prompt a search for occult halide exposure.
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Specialty: Endocrinology, Clinical Laboratory