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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sciendo
2023
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Materias: | |
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 |
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author | 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 |
author_facet | 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 |
author_sort | Ng, Wincy Wing-Sze |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-10448446 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Sciendo |
record_format | MEDLINE/PubMed |
spelling | pubmed-104484462023-08-25 Pyroglutamic Acidosis – An Underrecognised Entity Associated with Acetaminophen Use 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 Rom J Anaesth Intensive Care Case Report 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. Sciendo 2023-04-20 /pmc/articles/PMC10448446/ /pubmed/37635852 http://dx.doi.org/10.2478/rjaic-2023-0004 Text en © 2023 Wincy Wing-Sze Ng et al., published by sciendo https://creativecommons.org/licenses/by-nc-nd/3.0/This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. |
spellingShingle | Case Report 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 Pyroglutamic Acidosis – An Underrecognised Entity Associated with Acetaminophen Use |
title | Pyroglutamic Acidosis – An Underrecognised Entity Associated with Acetaminophen Use |
title_full | Pyroglutamic Acidosis – An Underrecognised Entity Associated with Acetaminophen Use |
title_fullStr | Pyroglutamic Acidosis – An Underrecognised Entity Associated with Acetaminophen Use |
title_full_unstemmed | Pyroglutamic Acidosis – An Underrecognised Entity Associated with Acetaminophen Use |
title_short | Pyroglutamic Acidosis – An Underrecognised Entity Associated with Acetaminophen Use |
title_sort | pyroglutamic acidosis – an underrecognised entity associated with acetaminophen use |
topic | Case Report |
url | 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 |
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