Severe Hypertriglyceridaemia Leading to Factitious Hypobicarbonataemia

  • Sasmit Roy Department of Internal Medicine, Centra Health, Lynchburg, VA, USA
  • Mohammed Ashraf Department of Internal Medicine, Centra Health, Lynchburg, VA, USA
  • Satbyul Sophia Kang Department of Internal Medicine, Centra Health, Lynchburg, VA, USA
  • Raul Ayala Department of Internal Medicine, Adventist Health, Hanford, CA, USA
  • Sreedhar Adapa Department of Internal Medicine, Kaweah Health Medical Center, Visalia, CA, USA


Factitious hypobicarbonataemia, metabolic acidosis


Anion gap metabolic acidosis is a laboratory finding commonly encountered in patients with sepsis, diabetic ketoacidosis, acute kidney injury and toxic alcohol ingestion. Serum blood chemistry assessment detects this abnormality. However, this can be falsely low in situations of high triglyceride levels due to lipid interference with measurement of the bicarbonate levels and through volume displacement by these large molecules. Arterial blood gas analysis and a lipid panel are required to confirm accurate bicarbonate levels. Clinicians handling acid-base disorders in hospitalized patients need to be aware of this spurious laboratory value to avoid unnecessary tests and to determine accurate total bicarbonate levels.



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  • Published: 2021-12-24

    Issue: 2021: Vol 8 No 12 (view)

    Section: Articles

    How to cite:
    Roy S, Ashraf M, Kang SS, Ayala R, Adapa S. Severe Hypertriglyceridaemia Leading to Factitious Hypobicarbonataemia. EJCRIM 2021;8 doi:10.12890/2021_003046.

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