Pyroglutamic Acidosis – An Underrecognised Entity Associated with Acetaminophen Use
Wincy Wing-Sze Ng
Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong Special Administrative RegionChai Wan, China
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, Hok-Fung Tong
Department of Pathology, Princess Margaret Hospital, Hong Kong Special Administrative RegionKowloon, China
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, Wai-Yan Ng
Department of Pathology, Princess Margaret Hospital, Hong Kong Special Administrative RegionKowloon, China
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, Joshua Ka-Ho Yeung
Department of Medicine & Geriatrics/ICU, Caritas Medical Centre, Hong Kong Special Administrative RegionKowloon, China
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, Joyce Kit-Yu Young
Department of Medicine & Geriatrics/ICU, Caritas Medical Centre, Hong Kong Special Administrative RegionKowloon, China
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, Raymond Kam-Wing Woo
Department of Medicine & Geriatrics/ICU, Caritas Medical Centre, Hong Kong Special Administrative RegionKowloon, China
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oraz Maureen Mo-Lin Wong
Department of Medicine & Geriatrics/ICU, Caritas Medical Centre, Hong Kong Special Administrative RegionKowloon, China
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20 kwi 2023
O artykule
Kategoria artykułu: Case Report
Data publikacji: 20 kwi 2023
Zakres stron: 26 - 30
DOI: https://doi.org/10.2478/rjaic-2023-0004
Słowa kluczowe
© 2023 Wincy Wing-Sze Ng et al., published by sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
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.