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VOLUME 23 , ISSUE 7 ( July, 2019 ) > List of Articles

CASE REPORT

5-oxoprolinuria (Pyroglutamic Aciduria) and Metabolic Acidosis: Unraveling the Mystery

Florence Benita, Narendra Nath Jena, Sambathkumar Sasikumar, Ponniah Thirumalaikolundusubramanian

Keywords : 5-oxoprolinuria, Metabolic acidosis, N-acetyl cysteine, Paracetamol therapy, Recovery, Risk/precipitating factors

Citation Information : Benita F, Jena NN, Sasikumar S, Thirumalaikolundusubramanian P. 5-oxoprolinuria (Pyroglutamic Aciduria) and Metabolic Acidosis: Unraveling the Mystery. Indian J Crit Care Med 2019; 23 (7):342-343.

DOI: 10.5005/jp-journals-10071-23211

License: CC BY-NC 4.0

Published Online: 01-07-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

A case of high anion gap metabolic acidosis (HAGMA) and high level of 5-oxoprolinuria were noticed in an elderly female of 66 years who had multiple risk/precipitating factors and recovered well with N-acetyl cysteine infusion. This is reported in view of its rarity and to create awareness of this entity among medical students and practicing physicians who handles such cases in emergency room or critical care unit. Moreover they have to remember and investigate the cases of metabolic acidosis for 5-oxoprolinuia especially in susceptible individuals who are on paracetamol with or without other precipitating factors.


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  1. Dempsey GA, Lyall HJ, Corke CF, Scheinkestel CD. Pyroglutamic acidemia: a cause of high anion gap metabolic acidosis. Crit Care Med. 2000;28(6):1803–1807.
  2. Green TJ, Jaap Bijlsma J, Sweet D. Profound metabolic acidosis from pyroglutamicacidemia: an underappreciated cause of high anion gap matabolic acidosis. CJEM. 2010;12(5):449–452.
  3. Tailor P, Raman T, Garganta CL, Njalsson R, Carlsson K, Ristoff E. Recurrent high anion gap metabolic acidosis secondary to 5-oxoproline (pyroglutamic acid). Am J Kidney Dis. 2005 ;46(1):e4–e10.
  4. Armenian P, Gerona RR, Blanc PD, Wu AH, Mookherjee S. 5-oxoprolinemia causing elevated anion gap metabolic acidosis in the setting of acetaminophen use. J Emerg Med. 2012;43(1):54–57.
  5. Mehta A, Emmett J, Emmett M. GOLD MARK: an anion gap mnemonic for the 21st century. Lancet. 2008; 372(9642):892.
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