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Inborn Errors of Metabolism01:20

Inborn Errors of Metabolism

Phenylketonuria (PKU) is a protein metabolism disorder characterized by high blood levels of the amino acid phenylalanine. This results from a mutation in the gene responsible for phenylalanine hydroxylase, an enzyme that converts phenylalanine into tyrosine. When this enzyme is deficient, phenylalanine builds up in the blood, leading to symptoms such as vomiting, rashes, seizures, growth deficiency, and severe mental retardation. An early diagnosis and a diet restricting phenylalanine intake...
Pharmacogenetics of Phase II Enzymes: N-acetyltransferase, Thiopurine S-methyltransferase, UDP-glucuronosyltransferase01:27

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Phase II biotransformation reactions are essential for detoxifying and eliminating xenobiotics, including many pharmaceutical compounds. These reactions typically involve conjugation, the covalent attachment of polar endogenous groups such as glucuronic acid, sulfate, methyl, or acetyl moieties to functional groups introduced during Phase I metabolism. The resulting conjugates are more water-soluble, enabling efficient renal or biliary excretion.The major classes of Phase II enzymes include...
Phase II Reactions: Acetylation Reactions01:24

Phase II Reactions: Acetylation Reactions

Acetylation, a phase II biotransformation reaction, introduces an acetyl group to drugs or their metabolites. Acetyltransferase enzymes facilitate this reaction, which resembles α-amino acid conjugation due to the addition of a functional group to the drug molecule.
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Phase II Reactions: Glutathione Conjugation and Mercapturic Acid Formation01:22

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Glutathione, a tripeptide made up of glutamate, cysteine, and glycine, is a critical player in the detoxification of drugs and xenobiotics via a process known as glutathione conjugation or mercapturic acid formation. This phase II biotransformation reaction involves the covalent binding of glutathione to a drug or its metabolite, enhancing the compound's water solubility and enabling its excretion.
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Overview of Protein Metabolism01:21

Overview of Protein Metabolism

Proteins are broken down into amino acids during digestion. Unlike fats and carbohydrates, which are stored for later use, proteins are not. Instead, amino acids are either used to produce ATP through oxidation or contribute to the creation of new proteins for the growth and repair of the body. Any surplus amino acids from the diet are converted into glucose or triglycerides rather than excreted.
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Hepatic Encephalopathy

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Updated: Jul 9, 2026

Induction of Drug-Induced, Autoimmune Hepatitis in BALB/c Mice for the Study of Its Pathogenic Mechanisms
11:36

Induction of Drug-Induced, Autoimmune Hepatitis in BALB/c Mice for the Study of Its Pathogenic Mechanisms

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[Pyroglutamic acidemia associated with acetaminophen].

F J Alados Arboledas1, P de la Oliva Senovilla, Ma J García Muñoz

  • 1Unidad de Cuidados Intensivos Pediátricos, Complejo Hospitalario de Jaén, Spain. fjaladosarbol@supercable.es

Anales De Pediatria (Barcelona, Spain : 2003)
|December 7, 2007
PubMed
Summary
This summary is machine-generated.

Acetaminophen use may cause pyroglutamic acidemia, a rare condition leading to high anion gap metabolic acidosis. This diagnosis should be considered in patients with unexplained acidosis, especially those on acetaminophen.

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Last Updated: Jul 9, 2026

Induction of Drug-Induced, Autoimmune Hepatitis in BALB/c Mice for the Study of Its Pathogenic Mechanisms
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Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
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Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen

Published on: November 27, 2019

Area of Science:

  • Pediatric Nephrology
  • Clinical Toxicology
  • Biochemistry

Background:

  • High anion gap metabolic acidosis (HAGMA) is a critical condition requiring prompt diagnosis.
  • Acetaminophen (paracetamol) is a common antipyretic and analgesic agent.
  • Pyroglutamic acidemia is a rare metabolic disorder characterized by elevated pyroglutamic acid levels.

Observation:

  • A 16-month-old boy, recovering from hemolytic uremic syndrome, presented with abrupt-onset HAGMA unresponsive to standard treatments.
  • Other common causes of HAGMA, including sepsis, lactic acidosis, and salicylate intoxication, were excluded.
  • The patient was concurrently receiving acetaminophen for fever management.

Findings:

  • Blood and urine pyroglutamic acid levels were significantly elevated, confirming pyroglutamic acidemia.
  • Acetaminophen administration was identified as a potential contributing factor to the metabolic derangement.
  • Normal betahydroxybutyrate, acetoacetate, osmolarity gap, and amino acid levels ruled out other metabolic causes.

Implications:

  • This case highlights acetaminophen-induced pyroglutamic acidemia as a critical differential diagnosis for HAGMA in pediatric patients.
  • Clinicians should consider monitoring pyroglutamic acid levels in patients on acetaminophen presenting with unexplained HAGMA.
  • Early recognition and management of pyroglutamic acidemia are crucial to prevent severe complications.