Acetaminophen-Induced Anion Gap Metabolic Acidosis and 5-Oxoprolinuria (Pyroglutamic Aciduria) Acquired in Hospital

2005 ◽  
Vol 46 (1) ◽  
pp. 143-146 ◽  
Author(s):  
Benjamin D. Humphreys ◽  
John P. Forman ◽  
Kambiz Zandi-Nejad ◽  
Hasan Bazari ◽  
Julian Seifter ◽  
...  
Keyword(s):  
Metabolic Acidosis ◽  
Anion Gap ◽  
Pyroglutamic Aciduria

scholarly journals High anion gap metabolic acidosis secondary to pyroglutamic aciduria (5-oxoprolinuria): association with prescription drugs and malnutrition

2007 ◽  
Vol 44 (4) ◽  
pp. 406-409 ◽  
Author(s):  
G Brooker ◽  
J Jeffery ◽  
T Nataraj ◽  
M Sair ◽  
R Ayling
Keyword(s):  
Metabolic Acidosis ◽  
Prescription Drugs ◽  
Antibiotic Prescription ◽  
Pyroglutamic Acid ◽  
Metabolic Disturbance ◽  
Anion Gap ◽  
Uneventful Recovery ◽  
Hospital Treatment ◽  
Compromised Patients ◽  
Pyroglutamic Aciduria

Two cases of High Anion Gap Metabolic Acidosis (HAGMA) due to pyroglutamic acid (5-oxoproline) are described. In both cases the HAGMA developed during an episode of hospital treatment, in conjunction with paracetamol and antibiotic prescription, and the surviving patient made an uneventful recovery after the drugs were withdrawn. Clinicians need to be aware of this cause for metabolic acidosis because it may be a more common metabolic disturbance in compromised patients than would be expected, and the discontinuation of drugs implicated in the aetiology is therapeutic.

scholarly journals Transient 5-oxoprolinuria (pyroglutamic aciduria) with systemic acidosis in an adult receiving antibiotic therapy

1998 ◽  
Vol 44 (2) ◽  
pp. 336-340 ◽  
Author(s):  
Bernard L Croal ◽  
Alastair C A Glen ◽  
Christopher J G Kelly ◽  
Robert W Logan
Keyword(s):  
Metabolic Acidosis ◽  
Antibiotic Therapy ◽  
Urinary Excretion ◽  
Unusual Case ◽  
Complete Recovery ◽  
Anion Gap ◽  
Metabolic Defects ◽  
Causative Agents ◽  
Staphylococcal Pneumonia ◽  
Pyroglutamic Aciduria

Abstract 5-Oxoprolinuria is a recognized condition with increased urinary excretion of 5-oxoproline and is associated with a variety of inborn metabolic defects involving the series of enzyme-linked reactions known as the γ-glutamyl cycle. We report the unusual case of a 35-year-old woman who initially presented with staphylococcal pneumonia but went on to develop a transient high anion gap metabolic acidosis. The development and subsequent complete recovery from this acidosis were subsequently shown to be related in time to the intravenous administration of the antibiotics flucloxacillin and netilmicin. Analysis of the patient’s urine for organic acids revealed massively increased excretions of 5-oxoproline at the peak of her acidosis. We suggest that this patient developed a transient disturbance in the γ-glutamyl cycle involving the 5-oxoprolinase step, which resulted in accumulation of 5-oxoproline that caused a severe high anion gap metabolic acidosis. The administered antibiotics remain as possible causative agents.

An Unusual Case of Severe Anion Gap Metabolic Acidosis in a 3-year-old Girl

2021 ◽  
Vol 42 (Supplement 1) ◽  
pp. S46-S51
Author(s):  
Ryan M. Fredericks ◽  
George Sam Wang ◽  
Christine U. Vohwinkel ◽  
Jessica Kraynik Graham
Keyword(s):  
Metabolic Acidosis ◽  
Unusual Case ◽  
Anion Gap

scholarly journals Anion gap‐opening metabolic acidosis and urinary findings in the early diagnosis of ethylene glycol poisoning: A case report

2022 ◽  
Vol 10 (1) ◽  
Author(s):  
Kentaro Ukita ◽  
Kanako Otomune ◽  
Ryo Fujimoto ◽  
Kanako Hasegawa ◽  
Koichi Izumikawa ◽  
...  
Keyword(s):  
Case Report ◽  
Metabolic Acidosis ◽  
Early Diagnosis ◽  
Ethylene Glycol ◽  
Anion Gap ◽  
Ethylene Glycol Poisoning ◽  
Gap Opening

Recurrent High Anion Gap Metabolic Acidosis Secondary to 5-Oxoproline (Pyroglutamic Acid)

2005 ◽  
Vol 46 (1) ◽  
pp. e4-e10 ◽  
Author(s):  
Prayus Tailor ◽  
Tuhina Raman ◽  
Cheryl L. Garganta ◽  
Runa Njalsson ◽  
Katarina Carlsson ◽  
...  
Keyword(s):  
Metabolic Acidosis ◽  
Pyroglutamic Acid ◽  
Anion Gap

A teenager presenting with anuric acute renal failure and metabolic acidosis with a high anion gap: Questions

2020 ◽  
Vol 35 (12) ◽  
pp. 2253-2255
Author(s):  
Çağla Serpil Doğan ◽  
Gülşah Kaya Aksoy ◽  
Kadir Aras Demircan ◽  
Şenay Yıldırım
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Metabolic Acidosis ◽  
Anion Gap
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