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Too much of too little: xylitol, an unusual trigger of a chronic metabolic hyperchloremic acidosis


Homeopathic globules are frequently used in children as a first-line treatment. Most of these globules are coated with sugar substitutes like xylitol; these substitutes are known for their laxative effect. Our patient shows that consumption of globules coated with xylitol does not have only laxative effects. It may cause indeed considerable weight loss and life-threatening enteral bicarbonate loss by diarrhea when overdosed in an infant.

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Conflicts of interest

There is no conflict of interest for any of the authors involved in the paper. The authors have no financial relationship with any organizations.

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Correspondence to Vera Bernet.

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David Wille and Mathias Hauri-Hohl share first authorship.

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Wille, D., Hauri-Hohl, M., Vonbach, P. et al. Too much of too little: xylitol, an unusual trigger of a chronic metabolic hyperchloremic acidosis. Eur J Pediatr 169, 1549–1551 (2010). https://doi.org/10.1007/s00431-010-1249-9

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  • Children
  • Metabolic acidosis
  • Xylitol
  • Enteral bicarbonate loss