In Reply: Acid-base disturbances January 2017
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* Gregory W. Rutecki
* Shylaja Mani

We thank Dr. Emmett for his insightful comment. He is correct that in the case reported by Tan et al the elevated osmol gap was not a *direct* result of the patient’s presumed acetaminophen ingestion but more likely another unidentified toxic ingestion. The online version of our article has been modified accordingly (also see page [214](http://www.ccjm.org/lookup/volpage/84/214) of this issue).

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