Guilty as charged : unmeasured urinary anions in a case of pyroglutamic acidosis

A patient developed an unexplained metabolic acidosis with the characteristics of renal tubular acidosis. By correcting the serum anion gap for hypoalbuminaemia and analysing the urinary anions and cations, the presence of unmeasured anions was revealed. The diagnosis of pyroglutamic acidosis, cause...

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Veröffentlicht in:	Netherlands journal of medicine 2008-09, Vol.66 (8), p.351-353
Hauptverfasser:	ROLLEMAN, E. J, HOORN, E. J, DIDDEN, P, ZIETSE, R
Format:	Artikel
Sprache:	eng
Schlagworte:	Acetaminophen - adverse effects Acid-Base Equilibrium Acidosis - chemically induced Acidosis - diagnosis Acidosis - physiopathology Acidosis - urine Aged Anions Anti-Bacterial Agents - adverse effects Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Biological and medical sciences Cations Female Floxacillin - adverse effects General aspects Humans Medical sciences Pharmacology. Drug treatments Pyrrolidonecarboxylic Acid - blood Risk Factors
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Zusammenfassung:	A patient developed an unexplained metabolic acidosis with the characteristics of renal tubular acidosis. By correcting the serum anion gap for hypoalbuminaemia and analysing the urinary anions and cations, the presence of unmeasured anions was revealed. The diagnosis of pyroglutamic acidosis, caused by a combination of flucloxacillin and acetaminophen, was established. Strategies for solving complex cases of metabolic acidosis are discussed.
ISSN:	0300-2977 1872-9061