Recurrent Pyroglutamic Acidosis in the Context of Undiagnosed Liver Cirrhosis-A Case Report.

• 发表时间: Sep-Oct 2021
• 来源期刊: J Clin Exp Hepatol
• DOI: 10.1016/j.jceh.2020.10.004
• PMID: 34511825
• 文章类型: Case Reports
• 作者列表: Allen BJW,Abu Shanab AA,Anderson MR,Fogden EN

关键词: 5-Oxoprolinaemia; HIV, Human Immunodeficiency Virus; NAC, N-acetylcysteine; NAFLD, Nonalcoholic Fatty Liver Disease; NASH; NASH, Nonalcoholic Steatohepatitis; VBG, Venous Blood Gas; metabolic associated fatty liver disease; nonalcoholic fatty liver disease; pyroglutamic acidosis

Abstract

Metabolic associated fatty liver disease, previously known as nonalcoholic fatty liver disease, is the most common cause of chronic liver disease across all ethnic groups; however, it remains enormously underestimated.1 , 2 Sepsis, hepatotoxic medications and malnutrition in the acute settings on top of unknown cirrhosis can lead to decompensation and various metabolic complications. Pyroglutamic acidosis is a rarely recognised cause for unexplained high anion gap metabolic acidosis that is felt to be frequently underdiagnosed. Particular patients at risk include women, the elderly, those on regular paracetamol and those suffering with malnourishment or sepsis. Other risk factors include alcohol abuse and chronic liver disease (3). We present the case of a patient with recurrent episodes of pyroglutamic acidosis and encephalopathy in the context of undiagnosed nonalcoholic fatty liver disease with cirrhosis.