Sunday, June 14 (2015); Acid-Base Disturbance
This is a rare form of high anion gap metabolic acidosis, associated with the use of paracetamol, flucloxacillin and vigabatrin. In summary, pyroglutamic acidosis occurs due to glutathione depletion in patients who receive flucloxacillin or vigabatrin together with paracetamol. The key feature is loss of feedback inhibition because of glutathione depletion, which results in overproduction of pyroglutamic acid. This metabolic product is probably better known as 5-oxoproline, and can be tested for (typically, a urine sample is required).