title: An unusual cause of severe metabolic acidosis.
abstract: A 50-year-old man was transferred to the intensive care unit with high anion gap metabolic acidosis. Investigations suggested a diagnosis of pyroglutamic acidaemia. Factors contributing to the acidosis were medications (paracetamol and flucloxacillin), sepsis and renal failure. The acidosis resolved with supportive therapy and withdrawal of the drugs. It is important to recognise this treatable aetiology of metabolic acidosis.
authors.affiliation: Medical Intensive Care Unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India. peterjohnvictor@yahoo.com.au
authors.forename: John V
authors.initials: JV
authors.lastname: Peter
authors.forename: Natasha
authors.initials: N
authors.lastname: Rogers
authors.forename: Shailesh
authors.initials: S
authors.lastname: Murty
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Gerace
authors.forename: Richard
authors.initials: R
authors.lastname: Mackay
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Peake
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects*; D000138:Acidosis / Q000175:diagnosis / Q000209:etiology*; D058186:Acute Kidney Injury / Q000150:complications; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D005436:Floxacillin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011761:Pyrrolidonecarboxylic Acid / Q000097:blood* / Q000652:urine; D018805:Sepsis / Q000150:complications
chemical_list: D018712:Analgesics, Non-Narcotic; D000900:Anti-Bacterial Agents; D000082:Acetaminophen; D005436:Floxacillin; D011761:Pyrrolidonecarboxylic Acid