Pyroglutamic Acidosis – An Underrecognised Entity Associated with Acetaminophen Use

Pyroglutamic acidosis (PGA) is an underrecognized entity characterised by raised anion gap metabolic acidosis (RAGMA) and urinary hyper-excretion of pyroglutamic acid. It is frequently associated with chronic acetaminophen (APAP) ingestion. We report the case of a 73-year-old man with invasive pulmo...

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Detalles Bibliográficos
Autores principales: Ng, Wincy Wing-Sze, Tong, Hok-Fung, Ng, Wai-Yan, Yeung, Joshua Ka-Ho, Young, Joyce Kit-Yu, Woo, Raymond Kam-Wing, Wong, Maureen Mo-Lin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sciendo 2023
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10448446/
https://www.ncbi.nlm.nih.gov/pubmed/37635852
http://dx.doi.org/10.2478/rjaic-2023-0004
Descripción
Sumario:Pyroglutamic acidosis (PGA) is an underrecognized entity characterised by raised anion gap metabolic acidosis (RAGMA) and urinary hyper-excretion of pyroglutamic acid. It is frequently associated with chronic acetaminophen (APAP) ingestion. We report the case of a 73-year-old man with invasive pulmonary aspergillosis treated with voriconazole and APAP for analgesia with a cumulative dose of 160 g over 40 days. PGA was suspected as he developed severe RAGMA and common causes were excluded. Diagnosis was confirmed via urinary organic acid analysis which showed significant hyper-excretion of pyroglutamic acid. APAP was discontinued, and N-acetylcysteine (NAC) was administered. His RAGMA rapidly resolved following treatment.

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