An unusual cause of severe metabolic acidosis.
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.
Peter
John V
JV
Medical Intensive Care Unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India. peterjohnvictor@yahoo.com.au
Rogers
Natasha
N
Murty
Shailesh
S
Gerace
Rosemarie
R
Mackay
Richard
R
Peake
Sandra L
SL
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
D018712:Analgesics, Non-Narcotic; D000900:Anti-Bacterial Agents; D000082:Acetaminophen; D005436:Floxacillin; D011761:Pyrrolidonecarboxylic Acid