[Acetaminophen induced 5-oxoproline acidosis: An uncommon case of high anion gap metabolic acidosis].

We describe a case of 5-oxoproline (pyroglutamate) acidosis due to chronic acetaminophen ingestion at therapeutic dose in a 79-year-old inpatient. The pathophysiology of this condition is detailed, with abnormalities in the gamma-glutamyl cycle due to acetaminophen ingestion and severe chronic morbidities, resulting in glutathione and cysteine deficiency and then accumulation of 5-oxoproline. In HAGMA, when usual causes have been excluded, 5-oxoproline acidosis should be suspected in patients with chronic morbidities and acetaminophen ingestion. This diagnosis should be kept in mind because it generally resolves quickly with cessation of acetaminophen and administration of intravenous fluids.
PMID: 29157755 [PubMed - as supplied by publisher]

Source: Revue de Medecine Interne - November 22, 2017 Category: Internal Medicine Tags: Rev Med Interne Source Type: research