热谷氨酸酸中毒-与对乙酰氨基酚使用相关的未被充分认识的实体。

Q2 Medicine Romanian journal of anaesthesia and intensive care Pub Date : 2023-04-01 DOI:10.2478/rjaic-2023-0004

Wincy Wing-Sze Ng, Hok-Fung Tong, Wai-Yan Ng, Joshua Ka-Ho Yeung, Joyce Kit-Yu Young, Raymond Kam-Wing Woo, Maureen Mo-Lin Wong

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引用次数: 0

摘要

焦谷氨酸酸中毒(PGA)是一种未被充分认识的实体，其特征是阴离子间隙升高代谢性酸中毒(RAGMA)和尿中焦谷氨酸的高排泄。它通常与慢性对乙酰氨基酚(APAP)摄入有关。我们报告一例73岁男性侵袭性肺曲霉病患者，使用伏立康唑和APAP镇痛，累计剂量160 g，超过40天。当他出现严重的RAGMA时，怀疑PGA，排除了常见原因。通过尿有机酸分析证实诊断，显示明显的焦谷氨酸高排泄。停用APAP，给予n -乙酰半胱氨酸(NAC)。他的RAGMA在治疗后迅速消退。

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Pyroglutamic Acidosis - An Underrecognised Entity Associated with Acetaminophen Use.

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.

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来源期刊

Romanian journal of anaesthesia and intensive care Medicine-Emergency Medicine

CiteScore

2.30

自引率

0.00%

发文量

期刊介绍： The Romanian Journal of Anaesthesia and Intensive Care is the official journal of the Romanian Society of Anaesthesia and Intensive Care and has been published continuously since 1994. It is intended mainly for anaesthesia and intensive care providers, but it is also aimed at specialists in emergency medical care and in pain research and management. The Journal is indexed in Scopus, Embase, PubMed Central as well as the databases of the Romanian Ministry of Education and Research (CNCSIS) B+ category. The Journal publishes two issues per year, the first one in April and the second one in October, and contains original articles, reviews, case reports, letters to the editor, book reviews and commentaries. The Journal is distributed free of charge to the members of the Romanian Society of Anaesthesia and Intensive Care.