Metabolic acidosis and elevated pyroglutamic acid in a patient with multiple organ dysfunction syndrome and chronic acetominophen use

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Netharland Journal of Critical Care

2008, Volume 12, Issue 5 : 213-215

Article

Metabolic acidosis and elevated pyroglutamic acid in a patient with multiple organ dysfunction syndrome and chronic acetominophen use

van Raalte R.

Zandstra D.F.

van der Voort P.H.J.

Abstract

We report a case of a critically ill patient with a high anion-gap metabolic acidosis and liver failure due to chronic acetominophen use and alcohol abuse. The metabolic acidosis on admission was explained by the high lactate level, but further investigation showed high levels of pyroglutamic acid contributing to the metabolic acidosis. Withdrawal of acetominophen and treatment with N-acetylcysteine and haemofiltration lead to a rapid decline in pyroglutamic acid levels. Copyright ©2008, Nederlandse Vereniging voor Intensive Care. All Rights Reserved.

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