Causes
Osmol gaps are used as a screening tool to identify toxins.
Causes of an elevated osmol gap are numerous. Generally there are 4 main causes:
- alcohols
- sugars
- lipids
- proteins
All three are osmotically active substances found in humans. Accordingly intoxications as listed below are reasons for an increased osmolar gap. Alcohols
- ethanol intoxication
- methanol ingestion
- ethylene glycol ingestion
- acetone ingestion
- isopropyl alcohol ingestion
Sugars
- mannitol
- sorbitol
Lipids
- Hypertriglyceridemia
Proteins
- Hypergammaglobinemia (M. Waldenstroem)
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