Wincy Wing-Sze Ng, Hok-Fung Tong, Wai-Yan Ng, Joshua Ka-Ho Yeung, Joyce Kit-Yu Young, Raymond Kam-Wing Woo, Maureen Mo-Lin Wong
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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 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.
期刊介绍:
The Romanian Journal of Anaesthesia and Intensive Care is the official journal of the Romanian Society of Anaesthesia and Intensive Care and has been published continuously since 1994. It is intended mainly for anaesthesia and intensive care providers, but it is also aimed at specialists in emergency medical care and in pain research and management. The Journal is indexed in Scopus, Embase, PubMed Central as well as the databases of the Romanian Ministry of Education and Research (CNCSIS) B+ category. The Journal publishes two issues per year, the first one in April and the second one in October, and contains original articles, reviews, case reports, letters to the editor, book reviews and commentaries. The Journal is distributed free of charge to the members of the Romanian Society of Anaesthesia and Intensive Care.