PDF(Pubmed)
Abstract：
This case describes a rare occurrence of high anion gap metabolic acidosis due to chronic acetaminophen (paracetamol) usage, which can be confirmed by measuring 5-oxoproline (pyroglutamate), an organic acid metabolite. As acetaminophen is an extremely common drug prescribed in both inpatient and outpatient settings, a high degree of clinical suspicion is required to isolate it as the aetiology for metabolic acidosis. Management includes discontinuation of acetaminophen use and at times the supplementation of oral bicarbonate. Metabolic acidosis due to a high anion gap is commonly described by the mnemonic \'MUDPILES\' in daily practice. A newer mnemonic, \'GOLD MARK\' is proposed to be a more inclusive tool to assist in determining the cause of high anion gap metabolic acidosis, especially with such cases being reported.
摘要：
该病例描述了由于长期使用对乙酰氨基酚（扑热息痛）引起的高阴离子间隙代谢性酸中毒的罕见发生，这可以通过测量5-氧代脯氨酸（焦谷氨酸）来证实，有机酸代谢产物。由于对乙酰氨基酚是一种在住院和门诊环境中非常常见的药物，需要高度的临床怀疑才能将其分离为代谢性酸中毒的病因。管理包括停止使用对乙酰氨基酚，有时补充口服碳酸氢盐。由于高阴离子间隙引起的代谢性酸中毒在日常实践中通常由助记符“MUDPILES”描述。一个新的助记符，“GOLDMARK”被提议成为一种更具包容性的工具，以帮助确定高阴离子间隙代谢性酸中毒的原因，尤其是在报道此类案件的情况下。
