Pyroglutamic acid-induced metabolic acidosis: a case report.

Abstract

High anion gap metabolic acidosis due to pyroglutamic acid (5-oxoproline) is a rare complication of acetaminophen treatment (which depletes glutathione stores) and is often associated with clinically moderate to severe encephalopathy. Acquired 5-oxoprolinase deficiency (penicillins) or the presence of other risk factors of glutathione depletion such as malnutrition or sepsis seems to be necessary for symptoms development. We report the case of a 55-year-old women who developed a symptomatic overproduction of 5-oxoproline during flucloxacillin treatment for severe sepsis while receiving acetaminophen for fever control. Hemodialysis accelerated the clearance of the accumulated organic acid, and was followed by a sustained clinical improvement.

• Authors: S Luyasu, M M C Wamelink, L Galanti, A Dive
• Journal: Acta clinica Belgica (Acta Clin Belg) Vol. 69 Issue 3 Pg. 221-3 (Jun 2014) ISSN: 1784-3286 [Print] England
• PMID: 24694265 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Antipyretics
• Acetaminophen
• Floxacillin
• Pyrrolidonecarboxylic Acid

Topics

• Acetaminophen (adverse effects)
• Acidosis (chemically induced, diagnosis, therapy)
• Anti-Bacterial Agents (adverse effects)
• Antipyretics (adverse effects)
• Female
• Fever (drug therapy, etiology)
• Floxacillin (adverse effects)
• Humans
• Middle Aged
• Pyrrolidonecarboxylic Acid (adverse effects)