Multiple Electrolyte Imbalances and Mixed Acid-base Disorder Posing a Diagnostic Dilemma

A Case Report

Fortune O. Alabi; Christopher O. Alabi; Rafaela G. Basso; Nadia Lakhdar; Adebanke O. Oderinde


J Med Case Reports. 2020;14(15) 

In This Article


Hampton et al. reported that "a careful history will lead to the diagnosis 80% of the time",[1] but our patient's case is an example of a time when a carefully taken history may hinder determining the right diagnosis in a timely manner. The laboratory results in our patient clearly pointed to alcohol abuse. In order to prevent the cognitive biases of anchoring and premature closure, we decided to give the patient the benefit of the doubt and diligently explored other diagnostic possibilities based on her claim that she did not drink alcohol. This is a case where believing the laboratory results may have saved resources and prevented an unnecessary delay in diagnosis.