Pyroglutamic acidosis in a renal transplant patient. |
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| Authors: | Carole L Foot John F Fraser Daniel V Mullany |
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| Institution: | Critical Care Research Group, The Prince Charles Hospital, Rode Road, Chermside 4032, Brisbane, Australia. |
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| Abstract: | |
Introduction
| Metabolic acidosis is a common acid–base disorder in criticallyill patients. Elucidation of the cause usually commences withthe calculation of the anion gap. Increased anion gap metabolicacidosis is commonly due to lactic acidosis, renal failure,ketoacidosis as well as a multitude of drugs including toxicalcohols. Pyroglutamic acidosis (5-oxoprolinuria) is a rarecause of increased anion gap acidosis and has not previouslybeen reported in a renal transplant patient.
Narrative
| A 57-year-old married female presented to the hospital witha two day history of lethargy, anorexia and increasing dyspnoea.Her past medical history was extensive. Four years ago she hada renal transplant for medullary sponge kidneys which was failingdespite ongoing immunosuppression. Her baseline creatinine was0.22 mmol/l
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| Keywords: | Acid-base disorders acidosis glutathione renal transplant |
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