• Ann. Clin. Biochem. · Jul 2007

    Case Reports

    High anion gap metabolic acidosis secondary to pyroglutamic aciduria (5-oxoprolinuria): association with prescription drugs and malnutrition.

    • G Brooker, J Jeffery, T Nataraj, M Sair, and R Ayling.
    • Department of Anaesthetics, Derriford Hospital, Plymouth, UK.
    • Ann. Clin. Biochem. 2007 Jul 1;44(Pt 4):406-9.

    AbstractTwo cases of High Anion Gap Metabolic Acidosis (HAGMA) due to pyroglutamic acid (5-oxoproline) are described. In both cases the HAGMA developed during an episode of hospital treatment, in conjunction with paracetamol and antibiotic prescription, and the surviving patient made an uneventful recovery after the drugs were withdrawn. Clinicians need to be aware of this cause for metabolic acidosis because it may be a more common metabolic disturbance in compromised patients than would be expected, and the discontinuation of drugs implicated in the aetiology is therapeutic.

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