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NDT Advance Access originally published online on October 12, 2005
Nephrology Dialysis Transplantation 2005 20(12):2836-2838; doi:10.1093/ndt/gfi184
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Case Report

Pyroglutamic acidosis in a renal transplant patient

Carole L. Foot, John F. Fraser and Daniel V. Mullany

Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia

Correspondence and offprint requests to: Dr John F. Fraser, Critical Care Research Group, The Prince Charles Hospital, Rode Road, Chermside 4032, Brisbane, Australia. Email: j.fraser@uq.edu.au

Keywords: Acid-base disorders; acidosis; glutathione; renal transplant

The first 10% of the full text of this article appears below.



   Introduction
 
Metabolic acidosis is a common acid–base disorder in critically ill patients. Elucidation of the cause usually commences with the calculation of the anion gap. Increased anion gap metabolic acidosis is commonly due to lactic acidosis, renal failure, ketoacidosis as well as a multitude of drugs including toxic alcohols. Pyroglutamic acidosis (5-oxoprolinuria) is a rare cause of increased anion gap acidosis and has not previously been reported in a renal transplant patient.



   Narrative
 
A 57-year-old married female presented to the hospital with a two day history of lethargy, anorexia and increasing dyspnoea. Her past medical history was extensive. Four years ago she had a renal transplant for medullary sponge kidneys which was failing despite ongoing immunosuppression. Her baseline creatinine was 0.22 mmol/l . . . [Full Text of this Article]



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Increased Anion Gap Metabolic Acidosis as a Result of 5-Oxoproline (Pyroglutamic Acid): A Role for Acetaminophen
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