High Anion Gap Metabolic Acidosis and 5-Oxoprolinuria in a Hospital Setting Induced by Acetaminophen, Sepsis, and Malnutrition: A Case Report
2024

High Anion Gap Metabolic Acidosis and 5-Oxoprolinuria in a Hospital Setting Induced by Acetaminophen, Sepsis, and Malnutrition: A Case Report

Sample size: 1 publication Evidence: low

Author Information

Author(s): Muacevic Alexander, Adler John R, Al-saedi Zainulabdeen, Miqdad Mohammed A, Alatta Lina, Spinowitz Bruce, Kuo Sheng

Primary Institution: NewYork-Presbyterian Queens, New York, USA

Hypothesis

Can 5-oxoprolinuria be a significant cause of high anion gap metabolic acidosis in critically ill patients?

Conclusion

The case highlights the importance of recognizing 5-oxoprolinuria as a potential cause of metabolic acidosis in patients with sepsis and malnutrition.

Supporting Evidence

  • 5-oxoproline acidosis is increasingly recognized in critically ill patients.
  • The patient had a history of normal kidney function before hospitalization.
  • Despite treatment, the patient exhibited persistent high anion gap metabolic acidosis.
  • Elevated urine 5-oxoproline levels were identified, leading to a change in treatment.
  • N-acetylcysteine therapy was initiated to address the metabolic acidosis.

Takeaway

This study is about a sick man who got very ill from a medicine called acetaminophen, and doctors found out he had a special problem that made his body too acidic.

Methodology

Case report detailing the clinical course and management of a patient with high anion gap metabolic acidosis.

Limitations

The study is based on a single case report, limiting generalizability.

Participant Demographics

29-year-old male with a history of intellectual disability.

Digital Object Identifier (DOI)

10.7759/cureus.75253

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