Bromide intoxication secondary to pyridostigmine bromide therapy
D. M. Rothenberg, A. S. Berns, R. Barkin and R. H. Glantz
Department of Anesthesiology, Rush-Presbyterian St-Luke's Medical Center, Chicago, IL 60612.
The diagnosis of bromide intoxication is often aided by the detection of a
low or negative anion gap due to the laboratory detection of bromide as
chloride. A 59-year-old woman with myasthenia gravis who received a large
dose of pyridostigmine bromide developed postoperative psychosis and was
diagnosed as having bromide intoxication. The diagnosis was suspected in
the setting of a negative anion gap and only later confirmed by direct
measurement of the serum bromide level. To our knowledge , this is the
first reported case of bromide intoxication due to pyridostigmine bromide
administration.
