PDF(Pubmed)
Abstract：
Pyroglutamic acidosis (PGA) is an underrecognized entity characterised by raised anion gap metabolic acidosis (RAGMA) and urinary hyper-excretion of pyroglutamic acid. It is frequently associated with chronic acetaminophen (APAP) ingestion. We report the case of a 73-year-old man with invasive pulmonary aspergillosis treated with voriconazole and APAP for analgesia with a cumulative dose of 160 g over 40 days. PGA was suspected as he developed severe RAGMA and common causes were excluded. Diagnosis was confirmed via urinary organic acid analysis which showed significant hyper-excretion of pyroglutamic acid. APAP was discontinued, and N-acetylcysteine (NAC) was administered. His RAGMA rapidly resolved following treatment.
摘要：
焦谷氨酸酸中毒（PGA）是一种未被认可的实体，其特征是阴离子间隙代谢性酸中毒（RAGMA）升高和尿中焦谷氨酸排泄过多。它通常与慢性对乙酰氨基酚（APAP）摄入有关。我们报告了一例73岁的侵袭性肺曲霉病患者，用伏立康唑和APAP治疗40天的累积剂量为160g的镇痛。怀疑是PGA，因为他发展为严重的RAGMA，并且排除了常见原因。通过尿有机酸分析证实了诊断，该分析显示焦谷氨酸明显过度排泄。APAP已停产，施用N-乙酰半胱氨酸(NAC)。他的RAGMA在治疗后迅速解决。
